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Long-term Outcomes of Left Ventricular Assist Device (LVAD) in Children with Advanced Heart Failure: A Single-center Clinical Experience
Lijun Yang, Ru Lin, Qiang Shu
Children's Hospital, Zhejiang University School of Medicine
Background and Objectives: The left ventricular assist device (LVAD) is an emerging treatment option that can serve as a bridge to heart transplantation or an alternative solution for advanced heart failure. Since the application of LVAD in China has recently arised in the pediatric field, there is still a lack of sufficient summary of its clinical efficacy and outcomes in children. This study focuses on the application of LVAD in children with advanced heart failure due to cardiomyopathy and explores its long-term clinical outcomes.
Methods: Children who underwent LVAD implantation at Children's Hospital School of Medicine Zhejiang University were included and followed up. The cardiac function of the children was classified according to the New York Heart Association (NYHA) classification criteria and the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) criteria, and staged according to the American College of Cardiology (ACC) staging criteria. After discharge, the quality of life was scored using the Kansas City Cardiomyopathy Questionnaire (KCCQ).
Results: A total of 11 children with advanced heart failure due to dilated cardiomyopathy underwent LVAD implantation surgery from February 2023 to December 2024. After excluding 1 case of short-term postoperative death, a total of 10 children were followed up. Among them, there were 6 boys and 4 girls, with an age range of 6 to 14 years, and a weight range of 11 to 53 kg. Their cardiac function was NYHA class III-IV, INTERMACS class I-III, and ACC stage D. After a follow-up period of 3 months to 2 years, the physical fitness of the children increased significantly. All NYHA classes improved to class I, and the KCCQ scores increased significantly. In terms of complications, there were 2 cases of cable infection, 2 cases of heart failure, and 1 case of thrombosis. In terms of outcomes, 6 children returned to school, and 4 children stayed at home. Among them, 2 children underwent heart transplantation, and no cases died during the follow-up period.
Conclusion: The long-term clinical outcomes of implantable left ventricular assist devices in children with advanced heart failure due to cardiomyopathy suggest that the cardiac function of the children is significantly improved, and the quality of life can be significantly enhanced.