Hybrid procedure with pulsatile ventricular assist device for hypoplastic left heart syndrome awaiting transplantation

ISHLT consensus statement for the selection and management of pediatric and congenital heart disease patients on ventricular assist devices Endorsed by the American Heart Association

“…[174][175][176] There is increasing use of the paracorporeal CF devices with more durable cannulation in this population. [175][176][177][178] Inflow cannula is typically placed in the common atrium post atrial septectomy and the outflow cannula is placed into the ascending neoaorta post Norwood operation 174,175 or pulmonary artery after hybrid palliation (which may require graft extension) in HLHS. 174,177 The outflow cannula is placed in the aorta in PA/IVS both prior to or after shunt placement.…”

Developments in Pediatric Ventricular Assist Device Support

“…Despite their small size and challenges with balancing systemic and pulmonary circulations, support without complications is possible when innovative strategies are used. Philip et al 11 report a single-center experience of five patients with hypoplastic left heart variants. The patient weight ranged from 2.4 to 3.75 kg and longest duration of support was 164 days.…”

Sub‐acute neonatal hemochromatosis in an infant with hypoplastic left heart syndrome on ventricular assist device awaiting transplantation

“…The patient underwent surgical banding of the right and left pulmonary arteries, atrial septectomy, inflow VAD cannulation of the right atrium, outflow VAD cannula insertion into the main pulmonary artery, and 10 mL BH‐VAD placement, on cardiopulmonary bypass. A ductal stent was then deployed through a transventricular approach as previously described by our group …”

“…A ductal stent was then deployed through a transventricular approach as previously described by our group. 4 Initial VAD settings were a systolic pressure of 210 mm Hg, diastolic pressure of −20 mm Hg, and a pump rate 85 bpm, with 40% systole, generating a CI of 4 L/min/m 2 . Our institutional anticoagulation approach was initiated the day after surgery (Bivalirudin, goal aPTT of 60-90 seconds followed by initiation of Aspirin on POD 5).…”