Mechanical Circulatory Support in Pediatric Myocarditis: Utilization and Patient Outcomes

Purpose Myocarditis is a common cause of pediatric heart failure and may require treatment with mechanical circulatory support (MCS). The purpose of this study is to describe the frequency of MCS use in pediatric myocarditis, types of MCS used, and outcomes of patients who receive MCS. Methods This study utilized the administrative Kids’ Inpatient Database (KID), a nationally representative sample of discharge data. Five years of KID admissions (2003, 2006, 2009, 2012 and 2016) were queried using ICD-9/10 codes to identify those with a diagnosis of myocarditis. MCS strategies and outcomes were calculated and compared using logistic regression. Results Of 5,661 admissions for myocarditis, MCS was used in 194 (3.4%). ECMO was used in 82 (42.3%), a temporary ventricular assist device (tVAD) in 38 (19.6%), a durable VAD (dVAD) in 53 (27.3%) and combination MCS (cMCS) in 22 (11.3%). Half of admissions (n=2854, 50.4%), occurred in patients age 13-18 years, however teenagers were less likely than children Conclusion MCS is used in 1 in 30 pediatric myocarditis cases and patients who require MCS have higher morbidity and mortality. ECMO is the most commonly used MCS modality in pediatric myocarditis but there is no significant difference in mortality based on MCS modality.