Pulsatile pediatric ventricular assist devices: Current results for bridge to transplantation.

While pulsatile ventricular assist devices have gained widespread use in adult patients awaiting heart transplantation, only very limited experience with these devices exists in the pediatric population. In the past mostly non-pulsatile systems such as ECMO have been used to support pediatric patients with heart failure for very limited periods of time. Only recently have miniaturized pulsatile devices became available. This article describes the technical characteristics of these devices which have been implanted at the Deutsches Herzzentrum Berlin since 1992. The Berlin Heart assist device has since been used in 34 children between the ages of 6 days and 16 years. We report our strategy in patient selection, perioperative care and subsequent heart transplantation. The current literature on mechanical circulatory support in children is reviewed.