School Re-Integration for Pediatric VADs

Purpose Riding the successful curtails of adult ventricular assist device (VAD) designs, we are now able to discharge pediatric VADs into the community. An important aspect of quality of life for these patients is school re-integration. We sought to review the school re-integration process in this population. Methods and Materials We retrospectively reviewed all the patients at our institution from June 2010 to November 2012 with dischargeble VADs and their school attendance from inpatient to outpatient care. Results Seven patients received the Thoratec Heartmate II LVAS; patient age ranged from 10 to 18 (mean: 15). One patient was enrolled in college prior to admission, so did not participate in hospital school. Median length of inpatient stay was 66 days. For the remaining six patients, bedside instruction began on day 11 post implant and classroom instruction started on day 25. Two patients were transplanted prior to discharge and one patient is currently still hospitalized. Four patients were successfully discharged to the outpatient transition home closeby and concurrently attended hospital school. Upon transition home, one patient returned to his charter school and continues with hospital school as well, two patients returned to their public schools, and one patient received home schooling. One patient has been supported for 583 outpatient days. In this time period, he has only missed 29 school days for clinic visit and re-hospitalizations. Conclusions With proper support, education, and training, school re-integration for pediatric VADs is possible despite the complex care needs of these patients.