Ventricular assist devices in children

There has been much recent interest in the application of ventricular assist devices in children with end-stage heart failure. Though extracorporeal membrane oxygenation has long been the mainstay for such patients in North America, ventricular assist devices have many potential advantages for these kids. The increasing success of the Berlin Heart ventricular assist device in Europe has spawned much increased use of this device in North America. Active research is now ongoing to further develop and refine pediatric pumps. This manuscript reviews preoperative and postoperative considerations, with respect to the pediatric population undergoing insertion of a ventricular assist device, reviews current and future technology, and briefly presents the recent experience with the Berlin Heart at Saint Louis Children's Hospital.