European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery · 2026
Waitlist mortality in children with EXCOR support: An analysis of the Japan Excor registry.
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Hoashi Takaya, Asase Mariko, Sakaguchi Heima, Narita Jun, Ishido Mikiko, Urata Susumu, Toda Koichi, Murakami Takashi, Hirata Yoichiro, Hirata Yuichiro, Ono Minoru, Ueno Takayoshi, Fukushima Norihide
Аннотация
OBJECTIVES: To reveal the prognostic outcomes of ventricular assist device (VAD) therapy with EXCOR paediatric® in Japan.
METHODS: Patients who underwent EXCOR paediatric implantation as a bridging therapy to transplant between August 2012 and March 2025 were enrolled. The following risk factors were evaluated for their potential to influence waitlist mortality: early surgical era, primary diagnosis, age at implantation, weight at implantation, biventricular VAD support, preoperative extracorporeal membrane oxygenation support, and preoperative mechanical ventilator support.
RESULTS: The total number of 137 patients was identified. The median age and weight at the time of implantation were 15.4 months (interquartile range: 7.3-43.2) and 7.2 kg (5.5-10.9), respectively. The primary diagnosis was dilated cardiomyopathy in 100 patients (72.9%), congenital heart disease in 20 patients (14.6%), and restrictive cardiomyopathy in 8 patients (5.8%). Of those, 70 (51.0%) were supported for a period exceeding one year, and the one-year survival rate was found to be 92.9%. A weight of less than 5 kg at the time of Excor implantation was identified as the sole risk factor for mortality on the waitlist (p = 0.039, Hazard ratio: 2.43, 95% confidence interval: 1.05-5.68). In particular, the mortality rate of patients on the waiting list for congenital heart disease and restrictive cardiomyopathy was comparable to that of patients with dilated cardiomyopathy (p = 0.390, hazard ratio: 1.29, 95% confidence interval: 0.72-2.33).
CONCLUSIONS: An analysis of JEXCOR registry data demonstrated that the prognostic outcome of bridge-to-transplant therapy with Excor paediatric was favorable in Japan.
METHODS: Patients who underwent EXCOR paediatric implantation as a bridging therapy to transplant between August 2012 and March 2025 were enrolled. The following risk factors were evaluated for their potential to influence waitlist mortality: early surgical era, primary diagnosis, age at implantation, weight at implantation, biventricular VAD support, preoperative extracorporeal membrane oxygenation support, and preoperative mechanical ventilator support.
RESULTS: The total number of 137 patients was identified. The median age and weight at the time of implantation were 15.4 months (interquartile range: 7.3-43.2) and 7.2 kg (5.5-10.9), respectively. The primary diagnosis was dilated cardiomyopathy in 100 patients (72.9%), congenital heart disease in 20 patients (14.6%), and restrictive cardiomyopathy in 8 patients (5.8%). Of those, 70 (51.0%) were supported for a period exceeding one year, and the one-year survival rate was found to be 92.9%. A weight of less than 5 kg at the time of Excor implantation was identified as the sole risk factor for mortality on the waitlist (p = 0.039, Hazard ratio: 2.43, 95% confidence interval: 1.05-5.68). In particular, the mortality rate of patients on the waiting list for congenital heart disease and restrictive cardiomyopathy was comparable to that of patients with dilated cardiomyopathy (p = 0.390, hazard ratio: 1.29, 95% confidence interval: 0.72-2.33).
CONCLUSIONS: An analysis of JEXCOR registry data demonstrated that the prognostic outcome of bridge-to-transplant therapy with Excor paediatric was favorable in Japan.