关键词: 儿童, 心脏辅助装置, 植入后护理, 桥接, 心脏移植

Abstract:

This report summarized the nursing experience of a pediatric patient who underwent implantation of an axial-flow left ventricular assist device（LVAD） as a bridge to heart transplantation. As the first domestic application of an axial-flow LVAD specifically designed for low-weight children，due to the absence of prior therapeutic and nursing references. A multidisciplinary care team was established to provide comprehensive postoperative evaluation and management. Pump speed was precisely set and dynamically adjusted according to the patient’s body surface area and target cardiac output. Trends in cardiac function recovery were assessed by monitoring pulse pressure changes alongside circulatory parameters and patient’s condition. Notably，when pump speed remained constant，a transient increase in power exceeding 2W suggested the possibility of thrombus formation or embolization in the circuit. Given the characteristics of axial flow pumps causing significant red blood cell damage and reactive activation of the body’s anticoagulation system，a goal-directed anticoagulation strategy was adopted. Based on the family’s specific circumstances，media reports were utilized to mobilize social support for the child’s treatment，successfully bridging the case to a heart transplant.

Key words: Children, Cardiac Assist Devices, Post-Implantation Care, Bridging, Hear Transplantation