Ventricular Assist Devices in Children

Ventricular assist devices are life-saving mechanical pumps used to support heart function and blood flow in children with severe heart conditions.

Ventricular assist devices, sometimes called VADs, help the heart pump blood through the body when the heart is too weak to function on its own.

VADs can be used as a bridge to heart transplantation or, in some cases, as a long-term solution for heart failure.

Managing heart failure in children involves a multidisciplinary approach that may include medication, lifestyle changes and potentially surgical interventions such as VADs.

Early detection and diagnosis are crucial for successful treatment of heart conditions. Our team at WashU Medicine and St. Louis Children’s Hospital offers comprehensive screening programs designed to identify heart disease and congenital conditions that could lead to heart failure. Our experts, specializing in pediatric cardiology and cardiac surgery, work closely together to develop individualized treatment plans.

Why some children need VADs

Many children with heart disease can be treated with medical and surgical options.

Some forms of heart disease still resist common treatments.

For severe forms of heart disease, the best treatment may be heart transplant. While a child is waiting for a donor heart to become available, they need some form of support to keep their heart functioning.

A therapy called extracorporeal membrane oxygenation (also called ECMO) has been used to help with heart and lung function. ECMO can be helpful for heart and lung support, but there are risks to using ECMO for prolonged periods. The wait time for a donor heart might be long, meaning ECMO is not always the best option.

One reason some children might need a ventricular assist device—or VAD—is to help their heart pump blood while they wait for a donor heart to become available.

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The difference between VADs and ECMO

Ventricular assist devices (VADs) and extracorporeal membrane oxygenation (ECMO) are both forms of life support that can take over the work of the heart.

One key difference between a VAD and ECMO is that ECMO can provide support for both the heart and lungs, while a VAD typically helps the heart.

Another difference is that a child on ECMO needs to stay in the hospital, while children with certain types of VAD may be able to leave the hospital.

Conditions that may require a VAD

Heart disease and heart failure

Children may develop heart failure due to various reasons, including congenital heart defects, cardiomyopathies, or acquired heart diseases.

Symptoms of heart failure can include fatigue, rapid heartbeat, difficulty breathing and swelling of legs and abdomen.

Chronic conditions

Chronic conditions such as dilated cardiomyopathy, myocarditis and other forms of cardiomyopathy can also necessitate the use of VADs. Treatment often involves managing these underlying conditions through medication and regular monitoring.

VAD implant procedure

For children awaiting heart transplants, VADs provide vital support.

A VAD is connected to the child’s heart and blood vessels to help pump blood.

Usually, VAD placement involves open heart surgery. The device may be implanted inside the chest or outside the chest with tubes going to the heart.

There are different types of ventricular assist devices—including a Berlin Heart, an Impella, and other types of VADS—that can be used depending on the situation and the child’s needs. Our team will help determine which option may be best.

Potential complications and recovery

While VADs and transplants can be lifesaving, there are potential complications, such as infection, blood clots, or mechanical failure.

Recovery includes vigilant monitoring and managing any symptoms that happen.