Successful biventricular assist device Berlin heart implantation leading to heart transplant in a complicated pediatric case: an experience from a single center

The use of the Berlin heart EXCOR ventricular assist device (VAD) as a bridge to heart transplantation in pediatric patients has become increasingly widespread. This case report presents a detailed account of the successful implantation of a biventricular assist device (BIVAD) Berlin heart device in a complex pediatric case at the esteemed King Faisal Specialist Hospital and Research Center. The patient, diagnosed with dilated cardiomyopathy (DCM) and Kawasaki disease, underwent a series of interventions and treatments before requiring extracorporeal membrane oxygenation (ECMO) support and subsequently receiving the Berlin heart device. The post-implantation period was marked by significant challenges, including instances of bleeding and clot formation, necessitating multiple interventions and careful management. Ultimately, a heart transplant was performed; however, the patient encountered humoral rejection, leading to additional targeted treatment. Despite these intricate complications, the patient exhibited substantial improvement in left ventricular ejection fraction (LVEF) following the transplant, indicating a positive outcome. This case underscores the successful use of a BIVAD Berlin heart device as a viable bridge to heart transplantation in a complicated pediatric case, highlighting the crucial role of a multidisciplinary approach and meticulous management of complications throughout the entire treatment process.