Korean Circ J.  2017 Jul;47(4):509-515. 10.4070/kcj.2016.0311.

Outcomes Associated with the Off-label Use of Medical Devices in Congenital Heart Disease at a Single Institute

• Kong YH
• Song J
• Huh J
• Kang IS

• KMID: 2392889
• DOI: http://doi.org/10.4070/kcj.2016.0311

Abstract

BACKGROUND AND OBJECTIVES
While the off-label use of implantable medical devices for treating congenital heart disease is not uncommon, the present conditions and outcomes of their off-label use have rarely been described. Therefore, this study evaluated the prevalence and results of using implantable devices off-label to treat congenital heart disease at a single institute.
SUBJECTS AND METHODS
This was a retrospective study based on the medical records of catheter-based interventions for congenital heart disease performed from July 1, 1995 to June 1, 2015. The inclusion criterion was the off-label use of an implantable device. Patient demographic data, procedural success, and follow-up status regarding late complications were investigated, and the results of the off-label use of each device were compared.
RESULTS
Off-label use occurred in 144 of 1730 interventions with device implantation, accounting for 8.3% of the interventions. The median patient age and mean body weight were 51.0 months and 16.3 kg, respectively. Immediate and late failures were found in 9 cases, and 3 cases of mortality were not directly related to the devices used. The overall success rate was 93.8%. There were no long-term complications of the off-label use of occlusion devices. No procedural failures resulted from stent implantation, but one case of stent malposition and two cases of stent fracture were identified after procedure completion.
CONCLUSION
In general, the off-label use of implantable devices for treating congenital heart disease is safe and effective.

Keyword

Off-label; Medical device; Transcatheter therapy; Congenital heart defects

MeSH Terms

Body Weight
Follow-Up Studies
Heart Defects, Congenital*
Humans
Medical Records
Mortality
Off-Label Use*
Prevalence
Retrospective Studies
Stents

Figure

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  Fig. 1 The proportion of off-label medical implant uses in patients with congenital heart disease.

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  Fig. 2 The distribution of patient age at the time of transcatheter intervention with medical devices used off-label.

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