Clinical outcomes of pediatric ventricular assist device implantation: A single-institute report from Japan

Purpose: Numerous difficulties remain associated with pediatric heart transplantation. Therefore, the development of a ventricular assist device (VAD) specific to these cases is extremely important for therapeutic effectiveness. We present 5 cases of severe heart failure that were managed by ventricular assist device implantation, as a bridge to transplantation. Methods: We examined the clinical course of 5 patients (4 boys, 1 girl; mean age, 10.6 ± 1.5 years; range, 8-12 years) who underwent implantation of a pneumatic extracorporeal ventricular assist device between February 2004 and May 2009. Four patients had dilated cardiomyopathy and one had corrected transposition of the great arteries. Results: The mean period between onset of heart failure and ventricular assist device implantation was 594 ± 750 days (range, 94-1702 days), and the mean duration of ventricular assist support was 112 ± 98 days (range, 44-284 days). Four patients underwent heart transplantation overseas and one died of cerebral hemorrhage. Conclusions: Careful management of pediatric VAD patients and development of a device designed specifically for pediatric patients are essential for improving clinical outcomes in the future.