Purpose: To summarize and evaluate our center's experience with implantable left ventricular assist devices (LVADs) in treating children with end-stage heart failure, providing a reference for ventricular assist therapy in pediatric end-stage heart failure in China.
Method: A retrospective analysis was conducted on 13 children with end-stage heart failure who underwent LVAD implantation in our center between February 2023 and April 2025. Normally distributed continuous variables were expressed as mean ± standard deviation (x̄ ± s), non-normally distributed variables as median, and categorical variables as percentages. Postoperative mechanical ventilation duration, hospital stay, LVAD pump speed, and follow-up outcomes were compared and analyzed.
Result: A total of 13 pediatric LVAD implantations were performed, including 8 males and 5 females. The primary diagnosis was chronic heart failure due to dilated cardiomyopathy. Four patients had comorbid Duchenne muscular dystrophy (DMD), and 3 required ECMO support before LVAD implantation. The median age at surgery was 12.36 ± 1.08 years (range: 12 years–14 years 8 months), weight 40.37 ± 12.14 kg (range: 32–48.5 kg). Four cases underwent LVAD implantation with concomitant tricuspid annuloplasty. Average CPB time was 132.64 ± 27.61 minutes. Twelve patients showed favorable outcomes during follow-up, with significantly improved LVEF and well-functioning LVADs. One patient failed to wean from support and died on postoperative day 27.
Conclusion: LVAD implantation for pediatric end-stage heart failure at our center demonstrated generally positive outcomes, with 8 devices functioning beyond 1 year and 2 successful bridge-to-transplant cases. Implantable ventricular assist devices serve as an effective bridge to transplant, recovery, or destination therapy in children with end-stage heart failure.
Keywords: End-stage heart failure, LVAD, Surgical treatment, Mechanical circulatory support, Children
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