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Updated: May 10, 2026

Implantation of Total Artificial Heart in Congenital Heart Disease
Published on: July 18, 2014
Ethical considerations related to the use of mechanical support in congenital heart disease
Joseph W Rossano1, Beth D Kaufman, J Eduardo Rame
1Division of Cardiology, The Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. rossanoj@email.chop.edu
Abstract:
Heart failure frequently complicates congenital heart disease (CHD) in children and adults. In patients with end-stage disease, mechanical circulatory support may improve survival, quality of life, and serve as bridge to cardiac transplantation. There are many ethical issues surrounding the use of mechanical circulatory support in patients with CHD including the use of prospective and randomized trials, proper oversight of new therapies, and transparency in reporting. Additionally, there are ethical considerations relevant to the greater society as these therapies are highly resource intensive in a resource-limited society. This article will review the burden of disease of heart failure in patients with CHD, the challenges of mechanical circulatory support and heart transplantation, and the ethical considerations and problems that arise for this population.
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