Bridge to transplant in single-ventricle anatomy: subpulmonary support with EXCOR ventricular assist device associated with pulmonary artery reconstruction

Patients with a single ventricle circulation continue to be a challenge for a heart transplant. The patients in this cohort, often in poor clinical condition with frequent hepatic and renal impairment having undergone previous multiple surgical procedures, are often allosensitive and consequently ha...

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Bibliographic Details
Published in:European journal of cardio-thoracic surgery 2024-05, Vol.65 (5)
Main Authors: Domínguez Del Castillo, José Joaquín, Merino Cejas, Carlos Manuel, Gómez Guzmán, Elena, Frías Pérez, Manuel Angel
Format: Article
Language:English
Subjects:
Heart Transplantation
Heart Ventricles - abnormalities
Heart Ventricles - surgery
Heart-Assist Devices
Humans
Male
Pulmonary Artery - abnormalities
Pulmonary Artery - surgery
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Summary:Patients with a single ventricle circulation continue to be a challenge for a heart transplant. The patients in this cohort, often in poor clinical condition with frequent hepatic and renal impairment having undergone previous multiple surgical procedures, are often allosensitive and consequently have an increased risk of post-transplant complications. Although the most recently published series results are improved, this group of patients, with preserved ventricular function, continues to have a higher mortality rate. Moreover, the operation can be complicated by anatomical differences among the pulmonary arteries. This case report presents a child with tricuspid atresia and pulmonary vascular resistance contraindicating Fontan surgery, unfavourable anatomy of the central pulmonary arteries and in poor clinical condition. An EXCOR ventricular assist device (Berlin Heart) was used for sub- pulmonary mechanical circulatory support and pulmonary bifurcation reconstruction, as a bridge to a transplant.
ISSN:1873-734X
1873-734X
DOI:10.1093/ejcts/ezae174