Outcomes and Trends of Ventricular Assist Device Selection in Children with End-Stage Heart Failure

Jacob R. Miller, Timothy S. Lancaster, Deirdre J. Epstein, Nicholas C. Dupont, Kathleen E. Simpson, Chesney Castleberry, Charles E. Canter, Pirooz Eghtesady, Umar S. Boston

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


We aimed to examine trends in ventricular assist device (VAD) selection, continuous flow devices (CFD) versus pulsatile flow devices (PFD), and their associated outcomes in children eligible for both device types. To accomplish this, the United Network for Organ Sharing database was reviewed for pediatric patients listed for heart transplant (HT) from January 2007 to June 2014. Patients were included if a durable VAD was present at wait listing or when removed from the waiting list and who met size eligibility for a CFD (BSA > 1.0 m2). In total, 253 patients met inclusion criteria, 144 (57%) CFD and 109 (43%) PFD. Device type varied significantly based on year with CFD increasing from 11% in 2007 to 88% in 2014 (p < 0.01). PFD patients were younger, had a lower BSA, and an increased rate of extracorporeal membrane oxygenation and biventricular assist device support at listing. Survival to transplant or recovery was similar for CFDs and PFDs (96 vs. 94%; p = 0.57), as was the post-HT survival, 95% for both device types. Despite PFD patients having more risk factors for a poor outcome, survival was similar between device types. Even so, there is a dramatic trend toward CFD utilization in patients who are large enough to support one.

Original languageEnglish
Pages (from-to)464-469
Number of pages6
JournalASAIO Journal
Issue number4
StatePublished - 2017


  • cardiomyopathy
  • circulatory support devices
  • heart failure
  • pediatric
  • transplantation (heart)


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