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.