Related Experiment Video
Updated: Jul 2, 2025
Implantation of the Syncardia Total Artificial Heart
Published on: July 18, 2014
Intracorporeal LVAD implantation in pediatric patients: A single-center 10 years' experience
Irene Cao1, Enrico G Italiano1, Francesco Bertelli1
1Pediatric and Congenital Cardiac Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy.
Insights
Intracorporeal left ventricular assist devices (LVAD) are a feasible option for pediatric patients with a body surface area >1.0 m², with 3D imaging aiding in borderline cases. This approach shows promise for mechanical cardiac support in children.
Area of Science:
- Pediatric Cardiology
- Mechanical Circulatory Support
- Cardiac Surgery
Background:
- Mechanical cardiac support is vital for pediatric patients with heart failure.
- Evidence for intracorporeal devices in children remains limited.
- This study evaluates a decade of experience with intracorporeal LVADs in pediatric patients.
Observation:
- 11 pediatric patients (median age 13.9 years) received continuous-flow LVADs (HeartWare, HeartMate3).
- Dilated cardiomyopathy was the primary indication (72.7%).
- Preoperative advanced imaging and 3D reconstructions were used for implant selection, especially in smaller patients (BSA <1.2 m²).
Findings:
- No operative deaths occurred.
- The most common complication was bleeding requiring re-exploration (27.3%).
- One late death occurred due to neurological complications; remaining patients had no major late complications, and survivors underwent successful heart transplantation.
Implications:
- Intracorporeal LVAD implantation is a feasible and safe option for pediatric patients with BSA >1.0 m².
- 3D imaging and fit simulation are crucial for selecting appropriate candidates in borderline cases.
- This technology offers a viable mechanical cardiac support strategy for pediatric heart failure.
Background:
Mechanical cardiac support is currently an effective strategy to reduce morbidity and mortality in pediatric patients. However, solid evidence regarding the feasibility of intracorporeal devices in children still needs to be provided. We report our 10-year experience with intracorporeal left ventricular assist devices (LVAD) in children.
Materials And Methods:
We included all patients undergoing intracorporeal, continuous-flow LVAD implantation between 2012 and 2022. Baseline and postoperative data were collected from the institutional database.
Results:
Seven HeartWare and 4 HeartMate3 were implanted in 11 patients (median age 13.9 years, median body surface area - BSA - 1.42 m2, IQR 1.06-1.68). The most frequent indication to LVAD implant was dilated cardiomyopathy (72.7%). All candidates underwent a thorough preoperative advanced imaging. Three-dimensional reconstructions and implant fit simulation were performed when BSA was <1.2 m2, weight <30 kg, or internal transverse thoracic diameter <20 cm. There was no operative death. The most common postoperative complication was surgical re-exploration due to bleeding (27.3%). One patient died of severe neurological complications after about 3 months of hospitalization. No late deaths or unplanned re-hospitalizations occurred in the remaining 10, 6 of whom were discharged home. There were no major complications at the follow-up. All survivors underwent successful heart transplantation.
Conclusions:
Intracorporeal LVAD implantation proved to be a potentially feasible and safe option in young teenagers and children whose BSA was >1.0 m2. In borderline cases, the 3D reconstruction with implant fit simulation can effectively help to identify those patients who can safely undergo intrathoracic LVAD implantation.
More Related Videos
07:39Use of a Percutaneous Ventricular Assist Device/Left Atrium to Femoral Artery Bypass System for Cardiogenic Shock
Published on: August 16, 2021
06:10Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
Published on: June 12, 2021