ISHLT Consensus Statement for the Selection and Management of Pediatric and Congenital Heart Disease Patients on Ventricular Assist Devices

Published 19 May 2021

Angela Lorts, MD, MBA; Jennifer Conway, MD; Martin Schweiger, MD; Iki Adachi, MD; Shahnawaz Amdani, MD; Scott R. Auerbach, MD; Charlotte Barr; Mark S. Bleiweis, MD; Elizabeth D. Blume, MD; Danielle S. Burstein, MD; Ari Cedars, MD; Sharon Chen, MD; Melissa K. Cousino-Hood, PhD; Kevin P. Daly, MD; Lara A. Danziger-Isakov, MD, MPH; Nicole Dubyk, BScN, RN; Lucas Eastaugh, MBBS, FRACP, FCSANZ; Joshua Friedland-Little, MD; Robert Gajarski, MD; Asif Hasan, MB, BS, FRCS; Beth Hawkins, NP; Aamir Jeewa, MD; Steven J. Kindel, MD; Shigetoyo Kogaki, MD, PhD; Jodie Lantz, PCNS; Sabrina P. Law, MD; Katsuhide Maeda, MD; Jacob Mathew, MD; Lindsay J. May, MD; Oliver Miera, MD; Jenna Murray, NP; Robert A. Niebler, MD; Matthew J. O'Connor, MD; Mustafa Özbaran, MD; David M. Peng, MD; Joseph Philip, MD, FAAP; Leigh Christopher Reardon, MD; David N. Rosenthal, MD; Joseph Rossano, MD; Leonardo Salazar, MD; Kurt R. Schumacher, MD; Kathleen E. Simpson, MD; Brigitte Stiller, MD; David L. Sutcliffe, MD; Hari Tunuguntla, MD; Christina VanderPluym, MD; Chet Villa, MD; Peter D. Wearden, MD; Farhan Zafar, MD; Daniel Zimpfer, MD; Matthew D. Zinn, DO
Independent Reviewers: David Morales, MD; Jennifer Cowger, MD; Holger Buchholz, MD; Antonio Amodeo, MD

J Heart Lung Transplant. 2021 Aug; 40(8):709-732

• Advanced Heart Failure & Transplantation
• Anesthesiology & Critical Care
• Cardiology
• Cardiothoracic Surgery
• Consensus Document
• Infectious Diseases
• Mechanical Circulatory Support
• Nursing & Allied Health
• Pediatrics
• Pharmacy
• Publications & Journals
• Research & Immunology
• Standards & Guidelines

Heart failure (HF) is a significant cause of mortality in children and therefore there is interest in understanding the optimal way to support these children with Ventricular Assist Devices (VAD) to improve outcomes. VAD therapy is now regarded as an important treatment option in pediatric HF.

The immediate aim of VAD therapy is to provide hemodynamic stability for a failing circulation unresponsive to medical therapy. The VAD should be implanted before the development of severe end-organ dysfunction in order to optimize clinical outcomes. The goal is to improve tissue and organ perfusion, improve quality of life (QoL) and improve waitlist survival. Importantly, VAD therapy may not only lead to patient stability but may also afford the opportunity for patient rehabilitation prior to heart transplantation (HT).

ISHLT has recognized the importance of a consensus statement on the selection and management of pediatric and congenital heart disease (CHD) patients undergoing VAD implantation. Extensive literature searches were performed but due to the lack of comparative trials in pediatrics, this document was written as a literature review with expert opinion rather than based on level of evidence.

Read at JHLT

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