Successful Bridge to Orthotopic Cardiac Transplantation with Implantation of a HeartWare HVAD in Management of Systemic Right Ventricular Failure in a Patient with Transposition of the Great Arteries and Previous Atrial Switch Procedure

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• 作者：Michael B. Stokes ; MBBS ; FRACP^a ; ^{mbstokes83@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Pankaj Saxena ; FRACS ; PhD^b ; David C. McGiffin ; MBBS ; FRACS^b ; Silvana Marasco ; MBBS ; MS ; FRACS ; Grad Cert HSM ; M Bioeth^b ; Angeline S. Leet ; MBBS ; FRACP^a ; Peter Bergin ; MBBS FRACP^a
• 关键词：d-Transposition ; Ventricular assist device ; Pulmonary hypertension
• 刊名：Heart, Lung and Circulation
• 出版年：2016
• 出版时间：May 2016
• 年：2016
• 卷：25
• 期：5
• 页码：e69-e71
• 全文大小：369 K

文摘

A clinical case is described of a patient with a history of dextro-transposition of the great arteries (d-TGA) and prior atrial switch procedure who developed significant pulmonary hypertension whilst awaiting orthotopic cardiac transplantation. The increase in his pulmonary pressures necessitated de-listing for cardiac transplantation. A strategy of ventricular assist device (VAD) placement was then employed which provided improvement in his systemic cardiac output with left atrial off-loading to provide pulmonary vascular remodelling and consequently reduction in pulmonary vascular resistance (PVR). He was supported for a period of 408 days prior to successful orthotopic cardiac transplantation. A small number of cases with this abnormality undergoing VAD implantation have been described. Mechanical circulatory support has an important role in some patients with congenital heart disease.