**Author details**

While the proportion of patients who develop neurological dysfunction after implantation of pulsatile devices has been documented to be approximately 19–30%, the incidence of cerebral strokes in children supported by cf-VADs has not been well explored. A recent report from EUROMACS suggests that it may be as low as 0.1 events per patient year [29]. Similar to the EXCOR, UFH is started postoperatively and then switched to oral anticoagulation. Antiplatelet therapy is in most cases necessary and seems to be meaningful as the pump

Prolonged durable support in children of all ages and patients with CHD with VADs permits good survival to transplantation. While the Berlin Heart EXCOR remains the "golden standard" for small children, if biventricular is needed, and in some CHD scenarios, an increased miniaturization of VADs has increased cf-device use in these patient. Still, patient and device selection in these patients remain challenging and come with the need for care providers spe-

cialized in the field of pediatric/CHD MCS/VAD treatment.

The author does not have any conflict of interest concerning this chapter.

chamber lays intracorporeal.

**3. Conclusions**

100 Heart Transplantation

**Conflict of interest**

**Appendices and nomenclature**

HF heart failure

HTx heart transplantation

UFH unfractionated heparin

VAD ventricular assist device

TAH total artificial heart

BiVAD biventricular assist device CHD congenital heart disease

EXCOR Berlin Heart pediatric EXCOR

LVAD left ventricular assist device

MCS mechanical circulatory support

ECMO extracorporeal membrane oxygenation

Martin Schweiger and Michael Huebler

Address all correspondence to: martinl.schweigerr@kispi.uzh.ch

Department of Congenital Cardiovascular Surgery, University Children's Hospital, Zurich, Switzerland
