Ventricular Assist Device Implantation for Single Ventricle

Abstract

Due to the increasing number of patients with failing single ventricle physiology, there has been a growing interest in the use of ventricular assist device (VAD) in these patients. This article aims to provide the key principles, which we believe are important to achieve favorable outcomes in this population. These include: simplification of the procedure, minimization of deleterious effect of a space-occupying VAD in the thorax, and modification of physiology to improve compatibility with VAD support. Consideration of these key principles will improve the outcome of VAD support in complex single ventricle patients. Facing inevitable late deterioration, even after a series of successful single ventricle palliations, VAD support may become part of the routine single ventricle management strategy (ie, Stage 4).