Abstract： Objective:To summarize the early clinical characteristics, managements and outcomes of left ventricular assist device (LVAD) for advanced left heart failure in children with complex congenital heart diseases.Methods:Retrospective analysis was conducted for perioperative data of two patients with complex congenital heart diseases and advanced left heart failure undergoing cardiac malformation correction and LVAD implantation from January 2022 to December 2023. Both patients were 14-year-old boys. Case 1 (40 kg) with severe left ventricular outflow tract stenosis and advanced left heart failure underwent Konno procedure and LVAD implantation. LVAD rotation was maintained at 2200-2400 r/min with a flow rate of 2.2-2.4 L/min. Case 2 (43 kg) with massive aortic regurgitation complicated with advanced left heart failure underwent aortic biologic valve replacement plus LVAD implantation. LVAD speed was maintained at 2000-2200 r/min with a flow rate of 2.0-2.4 L/min. A literature review was conducted in the databases of PubMed, Web of Science, MEDLINE, China National Knowledge Infrastructure (CNKI) and Wanfang using the key words of "children", "left ventricular assist device (LVAD)", "intracorporeal" and "congenital heart disease" prior to October 2023.Results:In case 1, left ventricular ejection fraction (LVEF) recovered from 19% to 60% at Month 3 post-operation. Then LVAD was removed successfully. Size and function of left ventricle completely normalized at 1 year. Case 2 with massive aortic regurgitation complicated with advanced left heart failure underwent aortic biologic valve replacement plus LVAD implantation. LVEF spiked from 16% to 30% at 2 months postoperatively and was discharged with pump. Seven foreign related articles were retrieved. The results showed that hemorrhage, infection and right heart failure were the major adverse events.Conclusion:For children with advanced left heart failure after complex congenital heart disease surgery, LVAD implantation can effectively promote the reverse remodeling of failing left ventricle.