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Use of Two Intracorporeal Ventricular Assist Devices As a Total Artificial Heart
08:49

Use of Two Intracorporeal Ventricular Assist Devices As a Total Artificial Heart

Published on: May 11, 2018

Advanced therapies for congenital heart disease: ventricular assist devices and heart transplantation

Christina VanderPluym1, Simon Urschel, Holger Buchholz

  • 1Department of Cardiology, Children's Hospital Boston, and the Department of Pediatrics, Harvard Medical School, Boston, MA, USA.

The Canadian Journal of Cardiology
|May 21, 2013
PubMed

Insights

Ventricular assist devices (VADs) offer advanced cardiac support for children with congenital heart disease (CHD) when surgery fails or is not an option. VADs serve as a bridge to heart transplant (HT), improving outcomes in complex cases.

Area of Science:

  • Pediatric Cardiology
  • Cardiovascular Surgery
  • Transplantation Medicine

Background:

  • Improved management has increased survival for children with congenital heart disease (CHD).
  • A subset of CHD patients require advanced cardiac support due to failed surgical palliation or unsuitability for surgery.
  • Heart transplantation (HT) is limited by donor organ scarcity.

Purpose of the Study:

  • To review the evolving role of ventricular assist devices (VADs) in managing congenital heart disease.
  • To discuss challenges and considerations for VAD support and HT in pediatric CHD patients.
  • To focus on VAD implantation reasons, Fontan circulation support, HLA sensitization, and VAD impact on HT outcomes.

Main Methods:

  • Review of current literature on VADs and heart transplantation in congenital heart disease.
  • Analysis of VAD technology advancements and their application in pediatric populations.
  • Discussion of specific challenges including Fontan physiology and immune sensitization.

Main Results:

  • VADs are increasingly used as a bridge to heart transplant (HT) for CHD patients.
  • Improved VAD technology allows use in smaller children and complex congenital anatomies.
  • Key challenges include VAD support in Fontan circulation, HLA sensitization, and VAD's effect on HT outcomes.

Conclusions:

  • VADs are a vital advanced support option for pediatric CHD patients awaiting heart transplantation.
  • Addressing challenges like Fontan support and immune response is crucial for successful VAD and HT therapy.
  • Continued advancements in VADs and transplantation strategies are improving long-term survival and quality of life.

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