A Decade of Pediatric Ventricular Assist Device Support in Colombia, a Middle-Income Country

Heart transplantation is the main treatment for refractory end-stage heart failure in patients of all ages, but its use is limited by the availability of organs, especially in pediatric populations. The International Hospital of Colombia has been a pioneer and the single center with the capability in the country for providing ventricular assist device (VAD) support using the CentriMag/PediMag-Levitronix paracorporeal VAD for pediatric patients awaiting transplant, with over a decade of experience albeit with many challenges.

This retrospective study examines outcomes from 26 pediatric patients who received VAD support between 2012 and 2023.

Most patients were diagnosed with dilated cardiomyopathy (n = 20, 77%), had an average age of 8.5 years (SD 5.3), and ranged in weight from 5 to 59 kg. The median duration of VAD support was 50.5 days, with 17 (81%) of surviving patients (n = 21), successfully undergoing transplantation. Neurological injury was the most common complication, affecting 69% of patients. The overall survival rate to VAD support was 81% and patients with left ventricular assist devices (LVAD) showed a higher post-transplant survival rate compared to those with biventricular assist devices (BiVAD).

This comparative analysis highlights the challenges faced in Colombia, particularly in implementing advanced medical technologies in middle-income countries. Despite these constraints, the study demonstrates notable patient survival, suggesting that targeted efforts to improve resource allocation and technology access could further enhance results.