Rehabilitation in children with ventricular assist devices

Q: What is the clinical evidence from this study?

Study design: Review. Population: End-stage heart failure. Intervention: Ventricular assist devices and rehabilitation.

Matthew J. O’Connor

doi:10.1016/j.jhlto.2025.100310

May 31, 2025JHLT OpenOpen Access

Rehabilitation in children with ventricular assist devices

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Key result

VAD support enables multidisciplinary rehabilitation to boost quality of life in pediatric heart failure.

Why the study?

While ventricular assist devices reverse physiologic consequences of chronic heart failure in children, their ability to facilitate rehabilitation across exercise, nutritional, and psychosocial domains requires review.

Key Points

To review the effects of chronic heart failure on exercise, nutritional, and psychosocial rehabilitation, and examine how ventricular assist device therapy facilitates recovery across these domains in pediatric patients.
Synthesized clinical literature on pediatric ventricular assist device (VAD) support and its physiological impact on exercise, nutrition, and psychosocial functioning.
Evaluated outcomes and protocols from single-center pediatric cohorts, registry datasets including Pedimacs, and multicenter surveys from the ACTION network.
In a 29-patient cohort completing 2 to 3 exercise sessions weekly, no adverse events or premature discontinuations occurred across 864 total sessions.
Pediatric 6-minute walk distances increased significantly within 90 days post-implantation, whereas inability to ambulate at 1 month predicted on-device mortality and failure to achieve hospital discharge.
A multicenter survey revealed that only 38% of responding ACTION centers performed post-VAD exercise testing in children, primarily limited by staffing shortages, space constraints, and travel distances.

Structured PICO

P

Population

Children with chronic heart failure supported by ventricular assist devices.

I

Intervention

Rehabilitation (exercise, nutritional, and psychosocial) facilitated by ventricular assist devices

Comprehensive rehabilitation encompassing exercise, nutrition, and psychosocial support is essential for optimizing outcomes and quality of life in children supported by ventricular assist devices.

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Implication

Supports rehabilitation programs for children on ventricular assist devices; leaves open confirmation of quality-of-life and post-transplant benefits in prospective trials.

Abstract

Ventricular assist devices play a critical role in the management of end-stage heart failure, with a significant increase in their utilization in children over the past 20 years. While much attention has been given toward the success of ventricular assist devices in reversing the physiologic consequences of chronic heart failure, the ability of ventricular assist devices to facilitate rehabilitation should not be underestimated. For patients with chronic heart failure, rehabilitation can be understood to include exercise rehabilitation, nutritional rehabilitation, and psychosocial rehabilitation. In this review article, the effects of chronic heart failure on these 3 domains of rehabilitation are described, along with the impact of ventricular assist devices on these domains in children. Data demonstrating the effects of ventricular assist device therapy on rehabilitation are reviewed, and areas where opportunities for the improvement in care exist are identified as well.

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Cite This Study

Matthew J. O’Connor (2025) conducted a review in End-stage heart failure. Ventricular assist devices and rehabilitation was evaluated. Ventricular assist devices facilitate exercise, nutritional, and psychosocial rehabilitation in children with end-stage heart failure, which can improve quality of life and post-transplant outcomes.

synapsesocial.com/papers/6a6276bc437918011ec93e3b https://doi.org/10.1016/j.jhlto.2025.100310

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Rehabilitation in children with ventricular assist devices

Key Points

Structured PICO

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Rehabilitation in children with ventricular assist devices

Key Points

Structured PICO

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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