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Updated: Jun 1, 2026
Implantation of Left Ventricular Assist Device (LVAD) in Juvenile Landrace Swine: A LVAD Implantation Model of Pediatric Heart Failure
Published on: January 16, 2026
Left ventricular assist device support with a centrifugal pump for 2 months in a 5-kg child
Takafumi Inoue1, Takashi Nishimura, Arata Murakami
1Department of Cardiothoracic Surgery, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, Japan. takainoue-tky@umin.ac.jp
Insights
Left ventricular assist device (LVAD) support for infants under 5kg remains challenging. This case report details successful 2-month centrifugal pump support in a 4-month-old infant with dilated cardiomyopathy, highlighting potential for mid-term mechanical circulatory support.
Area of Science:
- Pediatric Cardiology
- Mechanical Circulatory Support
- Cardiothoracic Surgery
Background:
- Left ventricular assist device (LVAD) implantation outcomes in small children, especially those under 5kg, are often unsatisfactory.
- Mid-term and long-term mechanical support for pediatric heart failure remains a significant clinical challenge.
- Existing LVADs designed for pediatric use have limitations for very low-body-weight infants.
Observation:
- A 4-month-old infant diagnosed with dilated cardiomyopathy (DCM) required mechanical circulatory support.
- Extracorporeal centrifugal pump (ROTAFLOW®) support was initiated for 2 months in this low-body-weight infant.
- The infant experienced acceptable control of thrombosis during the support period.
Findings:
- This case represents the first report of successful 2-month LVAD support using a centrifugal pump in a child weighing under 5kg.
- Autopsy confirmed no significant thrombosis in the device components or cardiac chambers.
- The infant ultimately succumbed to sepsis, not device-related thrombosis.
Implications:
- Successful mid-term mechanical support with a centrifugal pump is feasible in extremely low-body-weight infants with severe heart failure.
- This approach may offer a viable option for pediatric patients awaiting heart transplantation or recovery.
- Further research and device development are warranted to improve long-term outcomes and reduce complications like sepsis in pediatric LVAD support.
Abstract:
The mid-term and long-term results of left ventricular assist device (LVAD) implantation for small children are still unsatisfactory. There have been few reports of LVAD implantation for more than a month in children weighing under 5 kg. We report the case of a 4-month-old female infant who survived for 2 months after being diagnosed with dilated cardiomyopathy (DCM) with extracorporeal centrifugal pump support. In recent years, although pumps designed for small children have been introduced and are used as a bridge to transplantation or recovery, mid-term or long-term mechanical support for small children with heart failure is still difficult. We managed to successfully provide support for a low-body-weight child with a centrifugal pump over a mid-term period. We achieved acceptable control of thrombosis, but eventually the infant died of sepsis. Autopsy revealed no prominent thrombosis in the perfusion cannula, drainage cannula, the pump, or the left ventricle. This is the first case report of LVAD support with the centrifugal pump, ROTAFLOW(®) (Maquet, Rastatt, Germany), for 2 months in a child weighing under 5 kg. Our method may potentially save severe heart failure children who need mid-term LVAD support.
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