Outcomes of Children Bridged to Heart Transplantation with VADs

This landmark Pediatric Heart Transplant Society study, “Outcomes of children bridged to heart transplantation with ventricular assist devices: a multi-institutional study,” was published in May 2006 in Circulation, a journal by the American Heart Association. This groundbreaking work showed that VADs can be successfully used in kids and even their early outcomes were far superior than those on ECMO. This set the stage for further development and application of VADs in children and congenital heart disease. 

Key Findings:
  • 99 pediatric VAD patients were listed for heart transplantation between January 1993 and December 2003 
  • VAD support as a bridge to transplantation was successful in 77% of patients (5% were bridge to recovery, and 17% died on VAD support)

In this paper, only 4% of children were bridged to transplant with VADs (from 1993-2003). It is incredible to see how far the field has come in 15 years. Now, a third of children are supported with VADs to transplant with much improved waiting list survival! There are now more durable and smaller device options available, less risky bivad support is being used, dramatically decreased risk of stroke, and some children can even be safely discharged home with their VADs.  

According to the Fourth Annual Pediatric Interagency Registry for Mechanical Circulatory Support (Pedimacs) Report published December 2020, the population of children supported with VADs is growing, there are more centers, expanding indications, and improved outcomes. By the numbers, 856 pediatric VAD patients were implanted between September 2012 and December 2019. Positive outcome (alive on device or bridge to transplantation and recovery) occurred in 82% at 6 months. Learn more about improved outcomes in the field by checking out the full Pedimacs report


Blume ED, Naftel DC, Bastardi HJ, Duncan BW, Kirklin JK, Webber SA; Pediatric Heart Transplant Study Investigators. Outcomes of children bridged to heart transplantation with ventricular assist devices: a multi-institutional study. Circulation. 2006 May 16;113(19):2313-9. doi: 10.1161/CIRCULATIONAHA.105.577601. PMID: 16702487.