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Ann Thorac Surg 2007;83:306-308
© 2007 The Society of Thoracic Surgeons

Case Reports

Bridge to Transplantation With a Left Ventricular Assist Device for Systemic Ventricular Failure After Mustard Procedure

Robert S. George, BS, MRCSa,b,c, Emma J. Birks, MRCP, PhDa,c,*, Rosemary C. Radley-Smith, FRCPb, Asghar Khaghani, FRCSa, Magdi Yacoub, FRSc

a Departments of Transplantation and Mechanical Circulatory SupportHarefield, Middlesex, United Kingdom
b Department of Pediatric Cardiology, Royal Brompton and Harefield NHS TrustHarefield, Middlesex, United Kingdom
c National Heart and Lung Institute, Harefield, Middlesex, United Kingdom

Accepted for publication March 14, 2006.

* Address correspondence to Dr Birks, Royal Brompton and Harefield NHS Trust, Hill End Rd, Harefield, UB9 6JH Middlesex, UK (Email: e.birks{at}rbhnt.nhs.uk).

After Mustard or Senning procedures, transplantation remains the only option for some patients who present at late stage with severe systemic (right) ventricular failure. In some circumstances these patients may require urgent mechanical circulatory support to bridge them to transplantation. The use of mechanical support poses considerable potential and actual specific problems both in terms of insertion and management of the device. We report the case of a 17-year-old patient who had a left ventricular assist device implanted from the right ventricle to the aorta for "end-stage" heart failure 15 years after the Mustard procedure. The specific problems are discussed and a management scheme is proposed.






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Copyright © 2007 by The Society of Thoracic Surgeons.