Kobayashi Ryan L, VanderPluym Christina J
Department of Cardiology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.
JHLT Open. 2025 Jul 1;9:100334. doi: 10.1016/j.jhlto.2025.100334. eCollection 2025 Aug.
The use of ventricular assist device (VAD) therapy for advanced heart failure in infants and children with single-ventricle (SV) congenital heart disease (CHD) has expanded rapidly. However, issues pertaining to patient size, developmental hemostasis, device availability, complicated anatomy, and complex modes of hemodynamic/circulatory failure associated with each stage of SV palliation make VAD support particularly challenging in this population. Over the last 20 years, there has been significant improvement in support outcomes for this complex population; however, survival and rates of adverse events still lag behind children with other diagnoses. Herein, we review current mechanical circulatory support approaches, ongoing challenges, and outcomes for patients with SV CHD.
心室辅助装置（VAD）疗法在患有单心室（SV）先天性心脏病（CHD）的婴幼儿晚期心力衰竭治疗中的应用迅速增加。然而，由于患者体型、发育性止血、设备可用性、复杂的解剖结构以及与SV姑息治疗各阶段相关的血流动力学/循环衰竭复杂模式等问题，VAD支持在这一人群中极具挑战性。在过去20年中，这一复杂人群的支持效果有了显著改善；然而，生存率和不良事件发生率仍落后于其他诊断的儿童。在此，我们综述了SV CHD患者目前的机械循环支持方法、持续存在的挑战及治疗结果。
