Use of HeartWare Ventricular Assist System for Systemic Ventricular Support of a Pediatric Patient After Mustard Procedure

Abstract

Background:

The HeartWare Ventricular Assist System is indicated to provide mechanical circulatory support of patients with intractable heart failure as a bridge to cardiac transplantation. We describe the use of this device to support the systemic right ventricle (RV) of a pediatric patient with New York Heart Association class IIIC congestive heart failure who had undergone Mustard procedure for D-transposition of the great vessels as an infant.

Case report:

A HeartWare ventricular assist device was implanted in the left chest of a 16-year-old female patient (body surface area 1.43 m²) who presented with edema and later deteriorated, developing acute kidney injury, dysrhythmia, and pulmonary edema.

Results:

The patient’s edema and acute kidney injury resolved after device placement. She was discharged home and successfully underwent device removal with heart transplant five months later.

Conclusion:

The HeartWare device may be used for extended support as a systemic RV in a pediatric patient. It is feasible to consider using the device in this patient population.