Document Detail

Mechanical circulatory support in patients with heart failure secondary to transposition of the great arteries.
MedLine Citation:
PMID:  20620085     Owner:  NLM     Status:  MEDLINE    
Advances in palliation of congenital heart disease have resulted in improved survival to adulthood. Many of these patients ultimately develop end-stage heart failure requiring left ventricular assist device implantation (LVAD). However, morphologic differences in the systemic ventricle of these patients require careful attention to cannula placement. We report on the evolution of our surgical technique for implanting LVADs in 3 patients with transposition of the great arteries and congenitally corrected transposition of the great arteries. Applying standard LV cannulation techniques to the systemic ventricle led us too anteriorly in our first patient, creating obstruction by the moderator band. Subsequent use of epicardial and transesophageal echocardiography allowed for intraoperative localization of the intracardiac muscular structures to identify the optimal cannulation site. The acute angle of the inflow cannula on the DeBakey LVAD (MicroMed Technology, Houston, TX) required flipping the device 180°. The HeartMate II device (Thoratec, Pleasanton, CA) could be shifted towards the midline. One patient underwent successful transplant and 2 are home waiting for a donor organ. We conclude from our experience that LVAD surgery can be safely performed in patients with congenital heart disease when implanted under echocardiographic guidance.
David L Joyce; Sheri S Crow; Ranjit John; James D St Louis; Elizabeth A Braunlin; Lee A Pyles; Paula Kofflin; Lyle D Joyce
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation     Volume:  29     ISSN:  1557-3117     ISO Abbreviation:  J. Heart Lung Transplant.     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-25     Completed Date:  2011-03-01     Revised Date:  2011-12-12    
Medline Journal Info:
Nlm Unique ID:  9102703     Medline TA:  J Heart Lung Transplant     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1302-5     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.
Department of Cardiothoracic Surgery, Stanford University Medical Center, 162 Charles Marx Way, Palo Alto, CA 94304, USA.
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MeSH Terms
Cardiovascular Surgical Procedures / methods*
Echocardiography, Transesophageal
Heart Failure / etiology*,  surgery*
Heart-Assist Devices*
Radiography, Thoracic
Transposition of Great Vessels / complications*,  genetics,  radiography
Treatment Outcome
Comment In:
J Heart Lung Transplant. 2011 Dec;30(12):1420-1   [PMID:  21906961 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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