title: Percutaneous right ventricular support during catheter ablation of intra-atrial reentrant tachycardia in an adult with a mustard baffle--a novel use of the Impella device.
abstract: Late sequelea following a Mustard operation for transposition of the great arteries (TGA) include atrial arrhythmias and dysfunction of the systemic right ventricle. Catheter mapping and ablation of atrial tachycardia in the setting of significant right ventricular dysfunction may result in hemodynamic compromise. We report the novel use of the Impella percutaneous microaxial flow pump to support cardiac output in an adult patient with a Mustard operation for TGA who experienced a cardiac arrest during a prior ablation attempt. The Impella device was placed via a retrograde approach across the aortic valve into the right ventricle providing hemodynamic stability for successful mapping and ablation of intra-atrial reentrant tachycardia.
authors.affiliation: Division of Pediatric Cardiology, Yale-New Haven Medical Center, New Haven, CT 036520, USA. stevefishberger@hotmail.com
authors.forename: Steven B
authors.initials: SB
authors.lastname: Fishberger
authors.forename: Jeremy D
authors.initials: JD
authors.lastname: Asnes
authors.forename: Nancy L
authors.initials: NL
authors.lastname: Rollinson
authors.forename: Michael W
authors.initials: MW
authors.lastname: Cleman
mesh_terms: D000328:Adult; D018780:Body Surface Potential Mapping; D002302:Cardiac Output / Q000502:physiology; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D006348:Cardiac Surgical Procedures / Q000379:methods; D017115:Catheter Ablation / Q000379:methods*; D003131:Combined Modality Therapy; D004562:Electrocardiography; D005500:Follow-Up Studies; D006353:Heart-Assist Devices; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D012720:Severity of Illness Index; D013612:Tachycardia, Ectopic Atrial / Q000175:diagnosis / Q000601:surgery* / Q000628:therapy; D014188:Transposition of Great Vessels / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome
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