Continuous-flow ventricular assist devices (CF-VADs), designed for patients with a body surface area (BSA) ≥1.2 m2, have improved survival free from stroke and device failure in adults compared with pulsatile devices. Initial experiences in larger children with these CF-VADs have been promising; however, a large proportion of children needing long-term support as a bridge to heart transplantation (HTx) have a BSA of ≤1 m2. These small children can be successfully supported with paracorporeal pulsatile devices, yet rates of thromboembolic events continue to be an ongoing concern.
Miera O, Kirk R, Buchholz H, et al. J Heart Lung Transplant 2016;35:679–81.