Myocardial functional recovery following durable ventricular assist device in children
Bibliographic record
Abstract
Background: Ventricular assist device (VAD) explantation following myocardial functional recovery (MFR) for heart failure (HF) is uncommon in children and is associated with a risk of HF recurrence. Material and Methods: Retrospective, single-center study of pediatric patients who were supported with durable VADs, both intracorporeal continuous flow devices (CFD) and paracorporeal pulsatile flow devices (PFD), between 2004 and 2022. Results: A total of 74 children, of which 43 were female, underwent VAD implantation (PFD = 61 and CFD = 14) at a median (interquartile range) age of 5.6 (0.8, 13.5) years and with a weight of 16.2 (7.5, 40.7) kg. From this cohort, we identified 9 of 75 (12%) children who underwent VAD explantation for MFR. Of those, 7 of 9 (77%) were under 2 years of age and 6 of 9 (67%) were supported for >90 days. Five patients had dilated cardiomyopathy, 3 with anomalous left coronary artery from pulmonary artery and 1 with tachycardia-induced cardiomyopathy. Six were listed for transplantation as a part of their HF management strategy following VAD implantation. After explant, 8 of 9 patients remained in HF remission with no symptoms and stable left ventricular function. One patient had a recurrence of HF following explantation after demonstrating MFR while on VAD support. Conclusions: MFR resulting in VAD explantation is feasible in children with chronic HF especially for those <2 years of age. Further work is needed to better identify the features that promote MFR and maintain it after explant.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".