Page 7 - VAD Guidelines
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Pediatric Ventricular Assist Device (VAD) Guidelines

               Critical to the successful deployment of VAD support is the process of timely and thoughtful evaluation.
               For each patient suffering from end-stage heart failure there is an ideal time for the use of VAD in the
               setting of unique size and anatomical constraints that pediatric patients often pose. Emergency use of
               ECMO or Impella can provide cardiovascular stability and allow a better evaluation of the options to be
               made.
                            Algorithm for Mechanical Support in Acute Heart Failure









































               Pre-Implant Evaluation

               Many of the tests and investigations prior to initiating mechanical support are part of routine heart
               failure and CVIVU management. More specialist testing is required prior to initiating VAD provided time
               permits.  A comprehensive list of investigations is available in Appendix 1. Pre VAD labs should also
               include LDH, HLA Ab screen and genetic testing (if appropriate). Likewise additional consults to
               important services for the management of these children are also necessary. A VAD implant requires
               medical, psychosocial and financial discussion if possible prior to a decision.
               Consults:
                CT Surgery                     Financial                      Palliative Care
                Infectious Disease             Dental Evaluation              Social Work
                Nutrition                      Child Life                     Psychology
                Pharmacy (Anticoagulation)     Chaplain
                If clinically indicated: Hematology, Neurology/Neuromuscular, Nephrology






               Updated 12/14/2018                                                                      page 7
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