title: The increasing importance of percutaneous mechanical circulatory assist device therapy in heart failure management.
abstract: BACKGROUND
  Advances in medical and surgical care have made it possible for an increasing number of patients with Congenital Heart disease (CHD) to live into adulthood. Transposition of the great vessels (TGV) is the most common cyanotic congenital cardiac disease where the right ventricle serves as systemic ventricle. It is not uncommon for these patients to have systemic ventricular failure requiring transplantation.
  
  
  METHODS
  Hemodynamic decompensation in these patients can be swift and difficult to manage. Increasingly percutaneous LVAD's such as the Impella (Abiomed, Mass, USA) are gaining popularity in these situations owing to their relative ease of placement, both in and outside of the operating room.
  
  
  CONCLUSIONS
  In this paper we demonstrate that Impella (IMP) CP placement through the axillary artery approach shows to be suitable option for short term cardiac support and improvement of end organ perfusion in anticipation of cardiac transplantation.
authors.forename: Ricardo A
authors.initials: RA
authors.lastname: Weis
authors.forename: Patrick A
authors.initials: PA
authors.lastname: Devaleria
authors.forename: Sarang
authors.initials: S
authors.lastname: Koushik
authors.affiliation: Department of Anesthesiology, Division of Cardiovascular and Thoracic Anesthesiology, Mayo Clinic Hospital, Phoenix, Arizona, USA.
authors.forename: Harish
authors.initials: H
authors.lastname: Ramakrishna
mesh_terms: D000328:Adult; D004867:Equipment Design; D006333:Heart Failure / Q000209:etiology* / Q000628:therapy*; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D014188:Transposition of Great Vessels / Q000150:complications*; D016896:Treatment Outcome