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Updated: May 22, 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
Ventricular assist device application as a bridge to pediatric heart transplantation: a single center's experience
1Department of Surgery, Division of Cardiovascular Surgery, National Taiwan University Hospital, Taipei, Taiwan.
Insights
Ventricular assist devices (VAD) offer extended support for pediatric end-stage heart failure, bridging patients to heart transplantation (HTx). Thromboembolic events are a significant complication impacting survival in these young patients.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Surgery
- Biomedical Engineering
Background:
- Limited mechanical circulatory support options exist for pediatric end-stage heart failure.
- Ventricular assist devices (VAD) offer longer support duration and fewer complications than extracorporeal membrane oxygenation.
- VADs serve as a crucial bridge to heart transplantation (HTx) or recovery.
Purpose of the Study:
- To evaluate the outcomes of pediatric patients with end-stage heart failure receiving left ventricular assist device (LVAD) support.
- To assess the efficacy and complications of LVADs as a bridge to HTx in children.
- To analyze survival rates and identify major complications associated with pediatric LVAD support.
Main Methods:
- Retrospective chart review of eight pediatric patients who underwent LVAD implantation.
- Patients had end-stage heart failure, NYHA class IV, with ejection fractions <15%.
- Data collected on LVAD support duration, HTx, complications, and survival.
Main Results:
- Six out of eight patients (75%) received HTx after a mean LVAD support of 43.2 days.
- Two patients (25%) died awaiting a suitable donor heart.
- Major complications included thromboembolic events (50%), bloodstream infections (75%), and driveline infections (50%).
Conclusions:
- VADs provide essential long-term support for pediatric patients with end-stage heart failure awaiting HTx.
- Organ shortage significantly impacts HTx rates in this population.
- Thromboembolic events represent a critical challenge to survival in pediatric VAD patients.
Objectives:
There are limited options for mechanical circulatory support to treat end-stage heart failure in pediatric patients. Although extracorporeal membrane oxygenation is commonly used in infants and children, ventricular assist devices (VAD) provide a longer duration of support with fewer complications before recovery or as a bridge to heart transplantation (HTx), as described herein.
Methods:
This retrospective chart review of eight patients transplanted from April 2008 to December 2011, after left ventricular assist device (LVAD) implantation due to end-stage heart failure. Their mean age was 12 years (9-15 y) and mean body weight, 48 kg (20-78). All were New York Heart Association functional class IV with mean left ventricular ejection fractions less than 15%.
Results:
The six patients (75%) received HTx after a mean LVAD support duration of 43.2 days; 2 (25%) died before a suitable heart became available. Their mean duration of LVAD support was 30 days. There were 4 (50%) who experienced clinically evident thromboembolic events: 3 (37.5%) cerebrovascular with 1 mortality and 1 (12.5%) as acute limb ischemia. Transient hemodialysis was performed in 4 (50%). Bloodstream infection identified in 6 (75%) was controlled with intravenous antibiotics. Driveline infection identified in 4 (50%) was treated successfully with local wound dressing changes and intravenous antibiotics. One 9-year-old boy died of rejection at 16 months after transplantation.
Conclusions:
Because of the organ shortage, pediatric patients have a low chance to undergo HTx. VAD provides long-term support for children with end-stage heart failure before a suitable heart becomes available. A thromboembolic event remains a major complication influencing their survival.
