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Considerations of valvular heart disease in children with ventricular assist devices

Ming-Sing Si1, Vikram Sood2, Reshma Biniwale1

  • 1Department of Pediatrics, Division of Pediatric Cardiology, University of Michigan, C.S. Mott Children's Hospital, Ann Arbor, MI, United States.

Frontiers in Cardiovascular Medicine
|April 10, 2023
PubMed

Insights

Ventricular assist devices (VADs) improve survival for children with end-stage heart failure. Careful assessment of valve issues is crucial for effective VAD support and patient outcomes.

Area of Science:

  • Pediatric Cardiology
  • Cardiovascular Surgery
  • Biomedical Engineering

Background:

  • Ventricular assist devices (VADs) are vital for treating pediatric heart failure.
  • VADs have significantly reduced mortality in children awaiting heart transplantation.
  • End-stage heart failure in children often involves valve regurgitation, complicating VAD therapy.

Purpose of the Study:

  • To review the role of VADs in pediatric heart failure.
  • To discuss the impact of valvular abnormalities on VAD efficacy.
  • To outline management strategies for pediatric VAD patients with valve disease.

Main Methods:

  • Literature review of VADs in pediatric heart failure.
  • Analysis of hemodynamic support challenges.
  • Discussion of clinical management strategies.

Main Results:

  • VADs are effective in reducing mortality for pediatric end-stage heart failure.
  • Significant semilunar and atrioventricular valve regurgitation is common in this population.
  • Valve abnormalities can compromise VAD efficiency and hemodynamic support.

Conclusions:

  • Careful preoperative assessment of valve function is essential for VAD selection and cannulation.
  • Addressing valve regurgitation is critical for optimizing VAD performance in children.
  • Tailored strategies are needed to manage complex pediatric VAD cases effectively.

Keywords:
heart failurepediatricvalve surgery (or cardiac surgery)valvular heart diseaseventricular assist device

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