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Ann Thorac Surg 2004;78:1066-1068
© 2004 The Society of Thoracic Surgeons

Case report

Bidirectional cavopulmonary shunt for acute right ventricular failure in an adult patient

Takashi Kunihara, MDa, Vakhtang Dzindzibadze, MDa, Diana Aicher, MDa, Hans-Joachim Schäfers, MDa,*

a Department of Thoracic and Cardiovascular Surgery, University Hospital Homburg, Homburg, Germany

Accepted for publication June 25, 2003.

* Address reprint requests to Dr Schäfers, Department of Thoracic and Cardiovascular Surgery, University Hospital Homburg, Kirrberger Strasse 1, Homburg/Saar D-66421, Germany
chhjsc{at}uniklinik-saarland.de

Right ventricular failure due to right coronary occlusion is an uncommon but serious complication of acute aortic dissection. We report a patient with right coronary occlusion from acute type A aortic dissection who developed right ventricular failure that persisted after proximal aortic repair, rendering weaning from extracorporeal circulation unsuccessful. With a bidirectional cavopulmonary shunt and the use of an intraaortic balloon, the patient could be weaned successfully from cardiopulmonary bypass. This procedure may be an alternative to a right ventricular assist device in selected candidates.




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