Bailout transcatheter closure of patent foramen ovale for refractory hypoxaemia after left ventricular assist device implantation.
We describe the interdisciplinary management of a 59-year old man with ischaemic cardiomyopathy on a HeartMate II left ventricular assist device (LVAD) and temporary right extracorporeal membrane oxygenation (ECMO) as a bridge-to-heart transplantation. He suffered refractory hypoxaemia due to massive right-to-left shunting by a patent foramen ovale (PFO), diagnosed after weaning off of temporary right ECMO. Percutaneous closure of the PFO was successfully achieved with an Amplatzer septal occluder device, which allowed the patient's extubation and departure from hospital. The patient received heart transplantation 7 weeks after LVAD implantation and was discharged from the intensive care unit 2 weeks after transplantation.
Department of Cardiology, DHU FIRE, AP-HP, Hôpital Bichat, Université Paris-Diderot, Sorbonne Paris-Cité, INSERM U-1148, Paris, France q.fischer75@gmail.com.
Quentin
Q
Fischer
Department of Cardiac Surgery (M.K.), Groupe Hospitalier Bichat-Claude Bernard, AP-HP, Paris, France.
Matthias
M
Kirsch
Department of Cardiology, DHU FIRE, AP-HP, Hôpital Bichat, Université Paris-Diderot, Sorbonne Paris-Cité, INSERM U-1148, Paris, France.
Eric
E
Brochet
Department of Cardiology, DHU FIRE, AP-HP, Hôpital Bichat, Université Paris-Diderot, Sorbonne Paris-Cité, INSERM U-1148, Paris, France.
Jean-Michel
JM
Juliard
D006328:Cardiac Catheterization; D009202:Cardiomyopathies / Q000150:complications / Q000601:surgery*; D015199:Extracorporeal Membrane Oxygenation; D054092:Foramen Ovale, Patent / Q000150:complications / Q000601:surgery*; D016027:Heart Transplantation; D006353:Heart-Assist Devices; D006801:Humans; D000860:Hypoxia / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D055989:Septal Occluder Device; D016896:Treatment Outcome
Atrial septal occluder device.; Heart transplantation; Hypoxaemia; Left ventricular assist device; Patent foramen ovale; Right ventricular assist device