National Multicenter Registry for Pediatric End-Stage Heart Failure in China

Inclusion Criteria: Patients who meet any of the following criteria despite receiving optimal guideline-directed medical therapy (GDMT): Severe and persistent heart failure symptoms \[New York Heart Association (NYHA) Class III (advanced) or IV\]; Significant cardiac dysfunction, defined as: Left ventricular ejection fraction ≤30% Isolated right ventricular failure Non-operable severe valvular or congenital abnormalities Persistently elevated B-type natriuretic peptide (BNP) or N-terminal pro-BNP (NT-proBNP) levels Severe diastolic dysfunction or left ventricular structural abnormalities (based on ESC definitions for heart failure with preserved ejection fraction \[HFpEF\] and heart failure with mildly reduced ejection fraction \[HFmrEF\]); Requirement of: High-dose intravenous diuretics (or combination diuretic therapy) for pulmonary/systemic congestion, OR Inotropic/vasoactive agents for low cardiac output, OR Management of malignant arrhythmias Resulting in \>1 unplanned hospital visits or admissions within the past 12 months; Severely impaired mobility due to cardiac causes with either: Inability to ambulate, OR 6-minute walk distance \<300 m, OR Peak oxygen consumption (PvO₂) \<12-14 mL/kg/min. - Exclusion Criteria: Concurrent life-limiting systemic disorders Structural cardiac lesions with indication for surgical/interventional correction -