Starting Pediatric VAD Program: Transforming Challenges into Opportunities; A Case Series of a Single Center

Area of Science:

• Pediatric Cardiology
• Cardiovascular Surgery
• Medical Device Technology

Background:

• Increasing prevalence of heart failure in pediatric and adult populations.
• Limited treatment options for end-stage pediatric heart failure unresponsive to medical therapy.
• Surgical interventions like heart transplantation and ventricular assist devices (VADs) are crucial.

Purpose of the Study:

• To present the initial experience with VAD implantation in pediatric patients with end-stage dilated cardiomyopathy.
• To outline the necessary steps for establishing a VAD program, including team training and organizational adjustments.

Main Methods:

• Retrospective review of the first seven pediatric patients undergoing VAD implantation.
• Primary indication for VAD implantation was end-stage dilated cardiomyopathy.

Main Results:

• Median age at implantation was 4.5 years; median VAD support duration was 39 days.
• Long-term survival was achieved in three patients.
• Causes of mortality included multiorgan failure, thromboembolic events, sepsis, and low cardiac output syndrome. Two patients required neurointervention for ischemic stroke.

Conclusions:

• Successful establishment of a pediatric VAD program necessitates the inclusion of multiple specialties.
• Comprehensive training and continuous learning for all team members are essential for program success.