Recommendations for paediatric operative techniques
Recommendation   Class   Level   References
Device selection in small children
Implantation of a device with patient-device size mismatch is not recommended.  III  C
If mid- to long-term mechanical circulatory support is anticipated, durable implantable or extracorporeal devices should be considered over extracorporeal life support.  IIa  B  [308–310]
In children in need of mechanical circulatory support, implantation of an intracorporeal continuous-flow left ventricular assist device and subsequent discharge home should be considered.  IIa  C  [275, 277, 278, 284, 285, 289, 290, 311]
Use of a SynCardia total artificial heart
In complex congenital heart disease, patients, especially those with biventricular failure, with an adequate chest cavity and/or adequate intrathoracic space, a TAH may be considered as a bridge to transplant or as destination therapy.  IIb  C  [301]
If a TAH placement is planned, a virtual fit/implantation is recommended.  I  C  [312–314]
Patients with congenital heart disease requiring mechanical circulatory support
It is recommended to have recently obtained documentation of cardiac morphological and ventricular physiological data after the last surgery, including the presence of shunts, collateral vessels and the location and course of great vessels in patients with congenital heart disease undergoing evaluation for mechanical circulatory support implantation.  I  C  [71, 275, 315, 316]
TAH: total artificial heart.