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Improved 6 Minute Walk Distance and Brain-Type Natriuretic Peptide After Continuous-Flow Ventricular Assist Device Placement in Children

Goldberg, Jason F.*; Schlosser, Robin S.; Walrath, James G.; Morris, Shaine A.; Elias, Barbara A.§; Price, Jack F.; Cabrera, Antonio G.; Denfield, Susan W.; Dreyer, Wiliam J.; Wang, Yunfei; Adachi, Iki§; Jeewa, Aamir

doi: 10.1097/MAT.0000000000000865
Pediatric Circulatory Support

Despite increasing continuous-flow ventricular assist device (CF-VAD) use in children, minimal data exist regarding the functional recovery and rehabilitation potential after device placement. We hypothesized that after CF-VAD implantation, children would demonstrate a time-limited improvement in 6 minute walk distance (6MWD) and brain-type natriuretic peptide (BNP). A retrospective cohort study of 27 patients was conducted, those <18 years of age at a tertiary-care center during the study period. Seventy-four percent were male; median age was 12.7 years. Six minute walk distance and BNP were evaluated within 365 days of implantation. Associations were examined before and after 90 days postimplantation because a plateau in both values was seen after 90 days. Data included 92 6MWD and 341 BNP values. In the first 90 days, 6MWD increased by 12 percent predicted (%P) per 30 days (P < 0.01); with no significant change thereafter, increasing 0.6 %P per 30 days (P = 0.482). In the first 90 days, BNP decreased by 59% per 30 days (P < 0.01); with no significant change thereafter, increasing 1.2% per 30 days (P = 0.561). Six minute walk distance and BNP improved after CF-VAD implantation, with a significant improvement only in the first 90 days. Routine use of 6MWD and BNP can help in assessment of functional recovery in children after CF-VAD placement.

From the *University of Tennessee Health Sciences Center, Memphis, Tennessee

Department of Physical Therapy, Texas Children’s Hospital, Houston, Texas

Section of Pediatric Cardiology, Baylor College of Medicine, Houston, Texas

§Section of Congenital Heart Surgery, Baylor College of Medicine, Houston, Texas

Division of Pediatric Cardiology, The Hospital for Sick Children, Toronto, Ontario, Canada.

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Submitted for consideration February 2018; accepted for publication in revised form July 2018.

Disclosure: Iki Adachi and Aamir Jeewa have served as consultants for HeartWare. Iki Adachi serves as a surgical proctor for HeartWare. The other authors have no conflicts of interest to report.

Presented in the form of an oral abstract at the 63rd ASAIO Annual Conference; June 2017; Chicago, IL.

Correspondence: Jason F. Goldberg, University of Tennessee Health Sciences Center, 49 N. Dunlap Street, Memphis, TN 38105. Email:

Copyright © 2019 by the American Society for Artificial Internal Organs