Rehabilitation in children with ventricular assist devices

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.