In the past 30 years, ventricular assist device (VAD) therapy has provided pediatric patients with severe heart failure new therapeutic options while awaiting treatment decision, recovery, or transplantation. 1 Since the first reported use of pediatric VADs in the 1990s, 2 pediatric VAD therapy has continued to increase. Recent estimates suggest that as many as one-third of pediatric patients who undergo heart transplantation are supported by VADs. 3 The emerging literature suggests that pediatric patients supported by VADs have similar survival after transplant when compared to patients without VADs, despite the VAD population having greater illness severity prior to implant. 4 Today, VAD therapy allows some pediatric patients to survive to transplant who may have previously suffered mortality from severe heart failure. 4 Despite increases in survival, VAD therapy is associated with other inherent medical risks, such as infection and stroke. 5 VAD