Successful interventional closure of a patent foramen ovale in a pediatric patient supported with a biventricular assist device.
We report on a 16-year-old boy after an event of cardiac arrest and initial treatment with a veno-arterial extracorporeal membrane oxygenator (ECMO). After a short stabilisation period a biventricular assist device (BVAD, Thoratec) was implanted. Although the BVAD was functioning well, the patient showed persisting hypoxemia. Transthoracic echocardiography revealed a patent foramen ovale with a high right-to-left shunt due to low aspiration pressures of the BVAD. The patient was successfully treated by interventional closure of the PFO with a 27-mm Amplatzer septal occluder and could easily be weaned from the respirator. Meanwhile the boy has successfully undergone heart transplantation. PFO has to be considered as a cause of arterial hypoxemia in patients supported with ventricular assist devices. The diagnosis of a PFO may be missed under ECMO-treatment. Interventional closure of a PFO can successfully be performed even if the patient is supported with a BVAD.
Loeffelbein
Florian
F
Department of Pediatric Cardiology, Children's University Hospital, Freiburg, Mathildenstrasse 1, 79106 Freiburg, Germany. florian.loeffelbein@uniklinik-freiburg.de
Schlensak
Christian
C
Beyersdorf
Friedhelm
F
Dittrich
Sven
S
D000293:Adolescent; D006348:Cardiac Surgical Procedures; D002311:Cardiomyopathy, Dilated / Q000150:complications / Q000601:surgery / Q000821:virology; D017023:Coronary Angiography; D003384:Coxsackievirus Infections / Q000150:complications / Q000821:virology; D029822:Enterovirus B, Human; D015199:Extracorporeal Membrane Oxygenation; D054092:Foramen Ovale, Patent / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D006323:Heart Arrest / Q000601:surgery* / Q000821:virology; D016027:Heart Transplantation; D006353:Heart-Assist Devices; D006439:Hemodynamics; D006801:Humans; D000860:Hypoxia / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D008297:Male; D016896:Treatment Outcome