title: Improved systemic saturation after ventricular assist device implantation in a patient with decompensated dextro-transposition of the great arteries after the Fontan procedure.
abstract: We report the successful implantation of a HeartMate II left ventricular assist device after a failed Fontan procedure in a patient with dextro-transposition of the great arteries. The patient had developed significant intrapulmonary arteriovenous shunting. Despite the theoretical risk of worsening intrapulmonary shunting due to the decrease in systemic vascular resistance after device implantation, our patient did well. He was discharged from the hospital in stable condition and had better oxygen saturation than before the device was implanted. To our knowledge, ours is the 2nd report of the use of a ventricular assist device after the failure of a Fontan procedure, and the first report concerning the effect of ventricular assist device implantation on intrapulmonary shunting.
authors: Ali Abdul
authors: AA
authors: Jabbar
authors: Wayne J
authors: WJ
authors: Franklin
authors: Leo
authors: L
authors: Simpson
authors: Andrew B
authors: AB
authors: Civitello
authors: Reynolds M
authors: RM
authors: Delgado
authors: O H
authors: OH
authors: Frazier
mesh_terms: D018729:Fontan Procedure / Q000009:adverse effects*; D006333:Heart Failure / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D016027:Heart Transplantation; D006353:Heart-Assist Devices; D006439:Hemodynamics; D006801:Humans; D008297:Male; D011474:Prosthesis Design; D013997:Time Factors; D014188:Transposition of Great Vessels / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D017211:Treatment Failure; D016277:Ventricular Function, Left; D055815:Young Adult
keywords: Arteriovenous shunt/etiology; Fontan procedure; cardiac surgical procedures/adverse effects; heart-assist devices; pulmonary circulation; recovery of function; transposition of great vessels/complications/physiopathology/surgery; treatment outcome; ventricular dysfunction/etiology