Ventricular Assist Devices for Pediatric Heart Disease

Mechanical Circulation Assist Devices are designed for the treatment of acute and chronic heart failure and can be applied for different indications and assist period. Treatments that are carried out with Ventricular Assist Device System (VADs) have improved over course of time, within the practical applications of pediatric cardiac surgery. Pulsatile devices being in the lead, paracorporeal assist devices and implantable ventricular assist devices all have fields of application. However, ECMO (Extracorporeal Membrane Oxygenator) treatment is still applied on infants and children. These systems are preferred to assist patients with respiratory failure after heart surgery. But, this assist remains for a short term and compulsorily puts the patients into intensive care. In recent years, so many new devices have been developed, such as easily intubated cannulas for children including infants and miniature pumps for pediatric use. These devices are recommended for mid and long term, which is more predominant than ECMO. They are applied successfully to assist bridge to recovery and bridge to transplantation. Here, an assessment is made for different types of contemporary devices, decision making and application strategy, device technology, implantation techniques, anticoagulation and follow-up, new generation assist devices that operate with pediatric ventricular assist device for the treatment of pediatric heart failure. Proverbially, in spite of the successful results, ECMO and centrifugal pumps are not suitable for every patient because of the reasons such as long period of stays in intensive care unit, lack of mobilization and shortness of operating time. VAD systems are developed for little children of previously which only ECMO was suitable for. With the VAD treatment of selected pediatric population, especially in the cases of myocarditis and cardiomyopathy, mobilization and low anticoagulation have been enabled and resulted in 90 % of survival rate. VAD is preferred instead of ECMO and if there is a need for circulation assist that exceeds 1-2 weeks, the complication rate decreases. These devices get more reliable day by day and they will play an effective role in future as a treatment method for the complex congenital heart diseases that aim for transplantation or bridging treatment for cardiac recuperation. Eventually, what is dreamt for future is to attain permanent solutions.