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Home Is Where the HeartWare Is

Preparing Pediatric Patients and Caregivers for Discharge to Home and Integration Into the Community

DiFusco, Leigh Ann; Patton, Ashley M.; White, Rachel M.; Bober, Carley M.; Miller, Kelley D.

doi: 10.1097/MAT.0000000000000846
VAD Coordinator Series

The Cardiac Center at The Children’s Hospital of Philadelphia has cared for patients with implanted ventricular assist device (VAD) technology since 1998. Historically, patients requiring VAD support were managed exclusively in the Cardiac Intensive Care Unit with the first medically stable transition to the Cardiac Care Unit (step-down) taking place in 2001. Patient management was confined to the inpatient setting, as the primary device used at the time was paracorporeal and not suitable for home use. Continuous-flow devices, such as the HeartWare HVAD, have gained popularity because of miniaturized size and lower profiles of side effects and adverse events, making them more suitable for home use. This article describes a single-center experience with transitioning the VAD-supported pediatric patient to the outpatient setting, highlighting outcomes, strategies, and lessons learned in order to support VAD patients and their caregivers in the hospital and community setting.

From the Cardiac Center, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania.

Submitted for consideration August 2017; accepted for publication in revised form February 2018.

Disclosure: The authors have no conflicts of interest to report.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text, and links to the digital files are provided in the HTML and PDF versions of this article on the journal’s Web site (

Correspondence: Leigh Ann DiFusco, The Children’s Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA 19104. Email:

Copyright © 2018 by the American Society for Artificial Internal Organs