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Updated: Feb 14, 2026
09:15
In Vitro Thrombosis Test for Ventricular Assist Devices
Published on: March 21, 2025
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Ventricular Assist Devices for Neonates and Infants
Katsuhide Maeda1, David N Rosenthal2, Olaf Reinhartz1
1Departments of Cardiothoracic Surgery, Stanford University, Stanford, California.
Summary
Pediatric ventricular assist devices improve heart transplant waitlist survival, but neonates and infants still face high mortality. Research focuses on improving outcomes for this high-risk group.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Surgery
- Biomedical Engineering
Background:
- Pediatric heart transplant waitlist survival has improved with ventricular assist devices (VADs).
- Neonates and infants experience very high waitlist mortality despite VADs.
- The Berlin Heart EXCOR is the only approved long-term VAD in the US but has limitations due to its paracorporeal, pulsatile technology.
Purpose of the Study:
- To review Stanford's ventricular assist device experience in patients under 1 year old since 2004.
- To identify survival differences among different pediatric heart conditions.
- To explore modifications aimed at improving outcomes in high-risk infants and neonates requiring VAD support.
Main Methods:
- Retrospective review of Stanford's VAD experience in patients less than 1 year old from 2004 onwards.
- Analysis of survival rates at 1, 3, and 5 years.
- Comparison of survival across patient groups: cardiomyopathy, end-stage congenital heart disease, and single ventricle.
Main Results:
- Overall 1-, 3-, and 5-year survival rates were 68%, 62%, and 49%, respectively.
- Statistically significant differences in survival were observed among the cardiomyopathy, end-stage congenital heart disease, and single ventricle groups.
- Modifications to anticoagulation, cannulation strategies, and preferential use of continuous flow pumps were implemented.
Conclusions:
- Survival rates for infants and neonates on VAD support remain a significant challenge.
- Tailored strategies, including anticoagulation, surgical approach, and device type, are crucial for improving outcomes.
- Ongoing trials, such as the PumpKIN trial with the Jarvik 2015, offer hope for future advancements.
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