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Updated: Jul 26, 2026
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Use of Two Intracorporeal Ventricular Assist Devices As a Total Artificial Heart
Published on: May 11, 2018
9.3K
Multicenter outcomes for ventricular assist device support for failed stage II palliation
Edon J Rabinowitz1,2, Mary Mehegan2, Anna Joong3
1Division of Pediatric Critical Care Medicine, Washington University in St Louis, St Louis, Missouri.
JHLT Open
|March 27, 2025
Summary
Systemic ventricular assist device (SVAD) use in failed stage II palliation (S2P) shows promising survival rates despite frequent complications. Further research is needed to optimize SVAD strategies for these complex pediatric patients.
Area of Science:
- Pediatric Cardiology
- Mechanical Circulatory Support
- Congenital Heart Disease
Background:
- Stage II palliation (S2P) is a complex surgical procedure for single ventricle physiology.
- Failure of S2P often necessitates advanced interventions like ventricular assist devices (VADs).
- Limited data exists on the outcomes of VAD use in patients with failed S2P.
Purpose of the Study:
- To evaluate the clinical course, complications, and survival of systemic VADs (SVADs) in patients after failed S2P.
- To identify factors associated with adverse events and mortality in this population.
Main Methods:
- Multicenter retrospective review of the Advanced Cardiac Therapies Improving Outcomes Network registry.
- Analysis of data from 34 patients implanted with SVADs between 2012 and 2022.
- Assessment of preimplant characteristics, device strategies, adverse events, and survival outcomes.
Main Results:
- The study identified 34 patients with a median age of 1.8 years requiring SVAD support post-S2P.
- Frequent adverse events included infection (47%), strokes (29%), and bleeding (26%).
- Survival to transplant or recovery was 76%, with 56% survival at 1-year postexplant.
Conclusions:
- SVAD support demonstrates encouraging clinical outcomes in failed S2P, despite high rates of adverse events.
- Center variability in device strategy exists, highlighting the need for further research.
- Multi-institutional collaboration is crucial for optimizing SVAD support strategies in this patient group.
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