Mechanical circulatory support in patients with heart failure secondary to transposition of the great arteries

David L. Joyce, Sheri S. Crow, Ranjit John, James D. St. Louis, Elizabeth A. Braunlin, Lee A. Pyles, Paula Kofflin, Lyle D. Joyce

Research output: Contribution to journalArticle

57 Citations (Scopus)

Abstract

Advances in palliation of congenital heart disease have resulted in improved survival to adulthood. Many of these patients ultimately develop end-stage heart failure requiring left ventricular assist device implantation (LVAD). However, morphologic differences in the systemic ventricle of these patients require careful attention to cannula placement. We report on the evolution of our surgical technique for implanting LVADs in 3 patients with transposition of the great arteries and congenitally corrected transposition of the great arteries. Applying standard LV cannulation techniques to the systemic ventricle led us too anteriorly in our first patient, creating obstruction by the moderator band. Subsequent use of epicardial and transesophageal echocardiography allowed for intraoperative localization of the intracardiac muscular structures to identify the optimal cannulation site. The acute angle of the inflow cannula on the DeBakey LVAD (MicroMed Technology, Houston, TX) required flipping the device 180°. The HeartMate II device (Thoratec, Pleasanton, CA) could be shifted towards the midline. One patient underwent successful transplant and 2 are home waiting for a donor organ. We conclude from our experience that LVAD surgery can be safely performed in patients with congenital heart disease when implanted under echocardiographic guidance.

Original languageEnglish (US)
Pages (from-to)1302-1305
Number of pages4
JournalJournal of Heart and Lung Transplantation
Volume29
Issue number11
DOIs
StatePublished - Nov 2010

Fingerprint

Transposition of Great Vessels
Heart Failure
Heart-Assist Devices
Catheterization
Heart Diseases
Equipment and Supplies
Transesophageal Echocardiography
Tissue Donors
Technology
Transplants
Survival

Keywords

  • congenitally corrected transposition of the great arteries
  • epicardial echocardiography
  • heart failure
  • mechanical circulatory support
  • systemic right ventricule
  • transposition of the great arteries

ASJC Scopus subject areas

  • Transplantation
  • Cardiology and Cardiovascular Medicine
  • Pulmonary and Respiratory Medicine
  • Surgery

Cite this

Joyce, D. L., Crow, S. S., John, R., St. Louis, J. D., Braunlin, E. A., Pyles, L. A., ... Joyce, L. D. (2010). Mechanical circulatory support in patients with heart failure secondary to transposition of the great arteries. Journal of Heart and Lung Transplantation, 29(11), 1302-1305. https://doi.org/10.1016/j.healun.2010.05.030

Mechanical circulatory support in patients with heart failure secondary to transposition of the great arteries. / Joyce, David L.; Crow, Sheri S.; John, Ranjit; St. Louis, James D.; Braunlin, Elizabeth A.; Pyles, Lee A.; Kofflin, Paula; Joyce, Lyle D.

In: Journal of Heart and Lung Transplantation, Vol. 29, No. 11, 11.2010, p. 1302-1305.

Research output: Contribution to journalArticle

Joyce, DL, Crow, SS, John, R, St. Louis, JD, Braunlin, EA, Pyles, LA, Kofflin, P & Joyce, LD 2010, 'Mechanical circulatory support in patients with heart failure secondary to transposition of the great arteries', Journal of Heart and Lung Transplantation, vol. 29, no. 11, pp. 1302-1305. https://doi.org/10.1016/j.healun.2010.05.030
Joyce, David L. ; Crow, Sheri S. ; John, Ranjit ; St. Louis, James D. ; Braunlin, Elizabeth A. ; Pyles, Lee A. ; Kofflin, Paula ; Joyce, Lyle D. / Mechanical circulatory support in patients with heart failure secondary to transposition of the great arteries. In: Journal of Heart and Lung Transplantation. 2010 ; Vol. 29, No. 11. pp. 1302-1305.
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