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Ventricular Assist Device Use in Single Ventricle Heart Disease: Current Outcomes and Considerations
T Miller Sisson1, Erin V Shea2
1Pediatric Cardiology, Duke Children's Pediatric and Congenital Heart Center, Duke University Medical Center, Durham, NC, USA. miller.sisson@duke.edu.
Current Cardiology Reports
|July 30, 2026
Summary
Ventricular assist device (VAD) use is increasing for single ventricle heart disease patients, with outcomes improving but still posing challenges. Careful management is crucial for optimizing VAD therapy in this complex population.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Congenital Heart Disease
Background:
- Congenital heart disease with single ventricle physiology presents unique management challenges.
- Ventricular assist device (VAD) utilization is growing in this patient group.
- VAD therapy requires understanding complex physiology and device mechanics.
Purpose of the Study:
- To review recent outcomes, physiologic considerations, and challenges of VAD therapy.
- To examine VAD use across all stages of single ventricle palliation.
- To provide insights for optimizing VAD management in pediatric patients.
Main Methods:
- Literature review of recent studies on VAD therapy in single ventricle patients.
- Analysis of survival data and adverse events associated with VADs.
- Discussion of physiologic considerations and device mechanics.
Main Results:
- Survival post-VAD implantation is improving for single ventricle patients but remains lower than for biventricular patients.
- Various continuous and pulsatile flow VADs exist, with limited FDA approval for pediatric use.
- Adverse effects are common across all stages of single ventricle palliation regardless of VAD type.
Conclusions:
- VAD therapy in single ventricle heart disease is feasible but associated with significant challenges.
- Optimizing VAD outcomes necessitates a deep understanding of patient-specific physiology.
- Continued research and device development are needed for this vulnerable population.
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