Swimming with an LVAD: a critical event in a paediatric patient after seawater exposure

BACKGROUND: Left ventricular assist devices are increasingly used in paediatric patients with end-stage heart failure. Although they improve survival and functional capacity, serious complications can occur. CASE: We report an 11-year-old girl with dilated cardiomyopathy supported by a left ventricular assist device (HeartMate 3) as a bridge to transplant. Despite periodic education about the use of a left ventricular assist device, she entered the sea, leading to driveline and battery seawater exposure. She presented with device alarms but was initially stable. Given the risk of corrosion, emergent battery and lead replacement were performed under intensive monitoring with inotropic support. She experienced transient hypotension during left ventricular assist device cessation but recovered uneventfully. CONCLUSION: This is the first paediatric case describing left ventricular assist device seawater exposure. The case highlights the importance of repeated education, psychological support, and preparedness for high-risk interventions. This case also underlines potential infectious and corrosive risks following seawater exposure.