**3. Conclusions**

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