Biventricular Failure in Dextro-transposition of the Great Arteries Corrected with the Mustard Procedure: VAD Support of the Systemic Ventricle is Enough

Abstract

Introduction

Miniaturization and surgical progress in the field of ventricular assist device (VAD) therapy will lead to an increasing use in grown-up patients with congenital heart disease (GUCH). VAD implantation in such patients, especially biventricular VAD (BVAD) placement, can be very challenging, potentially associated with high morbidity and mortality.

Methods and Results

We report on a 47-year-old male patient in terminal biventricular failure with pulmonary hypertension 40 years after a Mustard procedure. The patient was successfully provided with a HVAD (HeartWare; HeartWare Inc., Framingham, MA, USA) into the systemic ventricle as bridge to transplantation, with the sub-pulmonary ventricle left unsupported.

Discussion

We present our institutional strategy for VAD selection in these patients and highlight intra-corporeal VAD implantation technique.