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Updated: May 18, 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
Echocardiographic evaluation of ventricular assist devices in pediatric patients
Ritu Sachdeva1, Elizabeth A Frazier, Robert D B Jaquiss
1Department of Pediatrics, Division of Pediatric Cardiology, Arkansas Children's Hospital, Little Rock, Arkansas, USA. sachdevar@kidsheart.com
Insights
Echocardiography is crucial for managing children with ventricular assist devices (VADs). This imaging technique aids in pre-VAD assessment, device placement, and identifying complications in pediatric VAD patients.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Surgery
- Medical Imaging
Background:
- Ventricular assist devices (VADs) present unique challenges in pediatric patients due to small size and complex cardiac conditions.
- Biventricular assist devices (BiVADs) are often necessary for complex pediatric heart failure cases.
- Echocardiography plays a vital role in assessing and managing pediatric patients requiring VAD support.
Purpose of the Study:
- To describe the utility of echocardiography in the management of pediatric patients supported by VADs.
- To evaluate the role of echocardiography in pre-VAD assessment, intraoperative guidance, and post-implantation monitoring.
- To highlight echocardiography's effectiveness in identifying VAD-related complications.
Main Methods:
- Retrospective review of 32 pediatric patients who underwent VAD placement between May 2005 and May 2011.
- Collection of patient demographics, cardiac diagnoses, VAD details, and echocardiographic findings.
- Analysis of transthoracic and transesophageal echocardiography data from diagnosis to VAD explantation.
Main Results:
- The study included 32 pediatric patients (median age 3 years) with left ventricular assist devices (LVADs) or BiVADs.
- Decreased right ventricular function increased the likelihood of BiVAD placement (P = .026).
- Echocardiography identified pre-VAD shunts (n=11), post-implantation effusions (n=16), and hematomas (n=12), and showed reduced chamber dimensions and mitral insufficiency post-VAD.
Conclusions:
- Echocardiography is indispensable for managing pediatric VAD patients.
- It effectively assists in pre-VAD evaluation, intraoperative device placement, and recognition of VAD dysfunction.
- Echocardiography is crucial for identifying and managing post-implantation complications in pediatric VAD recipients.
Background:
The use of ventricular assist devices (VADs) in children is challenging because of small patient size, frequent structural heart disease, and the need for biventricular assist devices. This report describes the role of echocardiography in the management of children supported by VADs.
Methods:
A retrospective review of the records of all pediatric patients who underwent VAD placement between May 2005 and May 2011 was performed to collect demographics, cardiac diagnoses, details of VADs, and transthoracic and transesophageal echocardiographic findings from the time of initial diagnosis until VAD explantation.
Results:
The study included 32 patients (median age, 3 years; age range, 20 days to 16 years; median weight, 12.3 kg; weight range, 3.5-60 kg), 20 with left ventricular assist devices and 12 with biventricular assist devices. Diagnoses included dilated cardiomyopathy or myocarditis (n = 27) and congenital heart disease (n = 5). The median duration of support was 12 days (range, 1-141 days). Patients with decreased right ventricular function were 8 times more likely to undergo biventricular assist device placement compared with those with normal right ventricular function (P = .026). Pre-VAD intracardiac shunts were identified in 11 patients and intracardiac thrombus in one patient. Cardiac chamber dimensions and mitral insufficiency were significantly reduced after VAD implantation. Postimplantation pericardial effusions were recognized in 16 patients and pericardial hematomas in 12 patients.
Conclusions:
Echocardiography is invaluable in the management of pediatric patients receiving VADs. It is helpful in pre-VAD assessment, guiding intraoperative device placement, recognizing VAD dysfunction, and identifying postimplantation complications.
