Abstract：
OBJECTIVE: This study aims to explore characteristics and clinical outcomes of patients with congenital heart disease (CHD) in the European Registry for Patients with Mechanical Circulatory Support (EUROMACS).
METHODS: This is a retrospective study of EUROMACS participants receiving MCS as bridge-to-transplant, possible bridge-to-transplant, or rescue therapy/bridge-to-recovery from 2011 to 2023 (n = 5340). Adult and paediatric cohorts were analysed separately. The primary outcome was mortality on MCS; secondary outcomes included recovery, transplant and complications including bleeding, cerebrovascular events, and sepsis.
RESULTS: Among adult patients, mortality at 1-year was 33.3% among the CHD cohort vs 22.1% in the non-CHD cohort. Adult CHD patients had higher hazards of mortality within the first year after MCS implantation [hazard ratios 1.98, 95% confidence interval (CI) 1.35-2.91, P < 0.001] and bleeding events (subdistribution hazard ratios 2.10, 95% CI 1.40-3.16, P < 0.001) compared with non-CHD patients. Both associations remained significant after accounting for multiple mediators. Among paediatric patients, mortality at 1 year was 22.1% in the CHD cohort vs 17.3% in the non-CHD cohort (hazard ratios 1.39, 95% CI 0.83-2.32, P = 0.213).
CONCLUSIONS: Adult and paediatric patients with CHD on MCS have higher adverse event risk compared with non-CHD MCS patients, though children did not have greater risk of mortality. As the number of CHD patients requiring advanced heart failure management continues to grow, these findings can enhance informed decision-making.
BACKGROUND: Registry name: EUROMACS.
METHODS: This is a retrospective study of EUROMACS participants receiving MCS as bridge-to-transplant, possible bridge-to-transplant, or rescue therapy/bridge-to-recovery from 2011 to 2023 (n = 5340). Adult and paediatric cohorts were analysed separately. The primary outcome was mortality on MCS; secondary outcomes included recovery, transplant and complications including bleeding, cerebrovascular events, and sepsis.
RESULTS: Among adult patients, mortality at 1-year was 33.3% among the CHD cohort vs 22.1% in the non-CHD cohort. Adult CHD patients had higher hazards of mortality within the first year after MCS implantation [hazard ratios 1.98, 95% confidence interval (CI) 1.35-2.91, P < 0.001] and bleeding events (subdistribution hazard ratios 2.10, 95% CI 1.40-3.16, P < 0.001) compared with non-CHD patients. Both associations remained significant after accounting for multiple mediators. Among paediatric patients, mortality at 1 year was 22.1% in the CHD cohort vs 17.3% in the non-CHD cohort (hazard ratios 1.39, 95% CI 0.83-2.32, P = 0.213).
CONCLUSIONS: Adult and paediatric patients with CHD on MCS have higher adverse event risk compared with non-CHD MCS patients, though children did not have greater risk of mortality. As the number of CHD patients requiring advanced heart failure management continues to grow, these findings can enhance informed decision-making.
BACKGROUND: Registry name: EUROMACS.
摘要：
目的：本研究旨在探讨欧洲机械循环支持患者注册中心（EUROMACS）中先天性心脏病（CHD）患者的特征和临床结局。
方法：这是一项对接受MCS作为移植桥梁的EUROMACS参与者的回顾性研究，可能的桥梁移植，或2011年至2023年的抢救治疗/康复桥梁（n=5,340）。分别对成人和儿科队列进行分析。主要结果是MCS的死亡率；次要结果包括恢复，移植和并发症，包括出血，脑血管事件，还有败血症.
结果：在成年患者中，CHD队列1年死亡率为33.3%,非CHD队列为22.1%.与非冠心病患者相比，成人冠心病患者在MCS植入后第一年内的死亡率（HR1.9895％CI1.35-2.91，p<0.001）和出血事件（sdHR2.10，95％CI1.40-3.16，p<0.001）的风险更高。在考虑了多个调解员之后，这两个协会仍然很重要。在儿科患者中，冠心病队列1年死亡率为22.1%,非冠心病队列为17.3%(HR1.3995%CI0.83~2.32,p=0.213).
结论：与非CHDMCS患者相比，服用MCS的成人和儿科CHD患者具有更高的不良事件风险，尽管儿童没有更大的死亡风险。随着需要高级心力衰竭管理的CHD患者数量的持续增长，这些发现可以增强明智的决策。
方法：这是一项对接受MCS作为移植桥梁的EUROMACS参与者的回顾性研究，可能的桥梁移植，或2011年至2023年的抢救治疗/康复桥梁（n=5,340）。分别对成人和儿科队列进行分析。主要结果是MCS的死亡率；次要结果包括恢复，移植和并发症，包括出血，脑血管事件，还有败血症.
结果：在成年患者中，CHD队列1年死亡率为33.3%,非CHD队列为22.1%.与非冠心病患者相比，成人冠心病患者在MCS植入后第一年内的死亡率（HR1.9895％CI1.35-2.91，p<0.001）和出血事件（sdHR2.10，95％CI1.40-3.16，p<0.001）的风险更高。在考虑了多个调解员之后，这两个协会仍然很重要。在儿科患者中，冠心病队列1年死亡率为22.1%,非冠心病队列为17.3%(HR1.3995%CI0.83~2.32,p=0.213).
结论：与非CHDMCS患者相比，服用MCS的成人和儿科CHD患者具有更高的不良事件风险，尽管儿童没有更大的死亡风险。随着需要高级心力衰竭管理的CHD患者数量的持续增长，这些发现可以增强明智的决策。
