Ventricular assist device in univentricular heart physiology

Area of Science:

• Pediatric Cardiology
• Mechanical Circulatory Support

Background:

• Mechanical cardiac assistance is established for biventricular heart failure, bridging patients to transplantation or recovery.
• Experience with mechanical support in single ventricle (SV) physiology remains limited.
• Ventricular assist devices (VADs) are increasingly used in pediatric heart failure.

Observation:

• This report details two pediatric cases with SV physiology requiring mechanical support.
• Case 1: A 2-year-old male with hypoplastic left heart syndrome after Norwood procedures.
• Case 2: A 4-year-old female with a univentricular heart and severe right ventricular dysfunction post-cavopulmonary shunt.

Findings:

• Mechanical support via VADs was utilized in both terminally ill children with SV.
• The application of VADs in SV physiology presents a potential therapeutic avenue.
• Successful bridging to further treatment or recovery is the goal of VAD therapy.

Implications:

• These cases suggest VADs may be a viable option for managing advanced heart failure in SV patients.
• Further research and experience are needed to establish optimal VAD use in SV physiology.
• Mechanical circulatory support could expand treatment options for complex pediatric congenital heart disease.