Pediatric ventricular assist device (VAD)

What is a pediatric ventricular assist device (VAD)?

Ventricular assist devices (VAD) is a mechanical devices that pump blood for children with heart failure. Doctors do surgery to implant the device in a child’s failing heart. The device has a power cable that exits through the child’s abdomen and connects to a portable battery pack. 

Children need a VAD because they have a heart defect or disease that prevents their heart from pumping enough blood. Most children get a VAD while they prepare for heart transplant, but some keep their devices long-term.

VADs come in different sizes and designs. Currently, our team is trained to use seven different types, and the UT Southwestern physicians practicing at Children’s Health often participate in studies of new devices to add to our program. This allows us to treat children of all ages.

What are the benefits of a pediatric ventricular assist device (VAD)?

VADs can allow children who need a heart transplant to stay healthy and even return to normal life while they wait for a donor heart. Some children have their VADs for months or even years, and can get back to going to school, playing sports and participating in other normal childhood activities. 

The Heart Failure program at Children’s Health helps some children transition to life at home and school, which gives them the chance to rebuild their strength and be a kid again. To see if your child can go home with their VAD, talk to your child’s doctor.

What are the side effects of a pediatric ventricular assist device (VAD)?

Children with VADs take blood thinning medicine to make it easier for the device to pump blood. The medicine can cause side effects, including nosebleeds. Our team provides you with guidelines for dealing with incidents like that. Some children with VADs feel pain in the shoulder or arm. This is because the VAD may irritate nerves in their chest or back that connect to other parts of the body. We can prescribe medications that help with this pain.

What are the risks of a pediatric ventricular assist devices (VAD)?

The most common risk is a skin infection where the power cable exits the body. To avoid this, we teach you and your child how to clean the area carefully. 

In rare cases, children can experience a stroke. This can happen because their blood-thinning medicine causes bleeding in the brain, or because the medicine doesn’t work right and allows a clot to travel to the brain.

What are Children's Health's outcome metrics for pediatric ventricular assist devices (VAD)?

Our team has completed over 100 VAD surgeries. We provide 15-20 children with VADs every year. On average, these children have the same health outcomes as children with heart transplants.

What to expect with a pediatric ventricular assist device (VAD)

We provide complete inpatient and outpatient care for children with VADs.

What to expect before a pediatric ventricular assist device (VAD) surgery?

Many children get VADs soon after their heart problems develop. They come to the hospital with heart failure, and we have to treat it right away. We may try medication first, and monitor to see if they need other treatment. Or, we may schedule surgery immediately to give them a VAD.

What to expect during a pediatric ventricular assist device (VAD) surgery?

Implanting a VAD requires open-heart surgery. The procedure usually takes four to six hours. Afterward, your child will have a breathing tube and IV to give them medicine and nutrients. As soon as a child is ready after surgery, we remove the breathing tube and your child will start eating and drinking on their own.

What to expect after a pediatric ventricular assist device (VAD) surgery?

Your child will start rehabilitation as soon as possible after surgery.

The type of rehab will depend on your child’s needs, but may include: 

• Physical therapy (PT), to regain strength and stability

• Occupational therapy (OT), to get used to doing tasks and daily activities with their device

• Speech therapy, to manage issues with communication, eating or mental processing that may come up after surgery

We also give you and your child thorough education for operating and taking care of their device. That includes charging the battery pack, how to carry the pack in a shoulder bag or fanny pack, how to shower and other tasks.

About a month after surgery, children with certain types of VAD and signs of stable health can go home. To make sure you’re ready for that, we give caregivers more than 20 hours of special training and have you take a written test. You also spend a full day at the hospital being the sole caregiver, without help from nurses unless it’s necessary. These steps make sure you and your child understand the responsibilities that come along with having a VAD, including how to take the blood-thinning medicine and other prescriptions your child may have.

What questions should I ask my doctor about a pediatric ventricular assist device (VAD)?

• How many VADs have you implanted in children?

• Which VADs are you trained in?

• Do you have an outpatient program for kids with VADs?

• What other treatment options does my child have?