title: Successful Bridge to Orthotopic Cardiac Transplantation with Implantation of a HeartWare HVAD in Management of Systemic Right Ventricular Failure in a Patient with Transposition of the Great Arteries and Previous Atrial Switch Procedure.
abstract: A clinical case is described of a patient with a history of dextro-transposition of the great arteries (d-TGA) and prior atrial switch procedure who developed significant pulmonary hypertension whilst awaiting orthotopic cardiac transplantation. The increase in his pulmonary pressures necessitated de-listing for cardiac transplantation. A strategy of ventricular assist device (VAD) placement was then employed which provided improvement in his systemic cardiac output with left atrial off-loading to provide pulmonary vascular remodelling and consequently reduction in pulmonary vascular resistance (PVR). He was supported for a period of 408 days prior to successful orthotopic cardiac transplantation. A small number of cases with this abnormality undergoing VAD implantation have been described. Mechanical circulatory support has an important role in some patients with congenital heart disease.
authors.affiliation: Department of Advanced Heart Failure/Transplantation, The Alfred Hospital, Melbourne, Vic, Australia. Electronic address: mbstokes83@gmail.com.
authors.forename: Michael B
authors.initials: MB
authors.lastname: Stokes
authors.affiliation: Department of Cardiothoracic Surgery, The Alfred Hospital, Melbourne, Vic, Australia.
authors.forename: Pankaj
authors.initials: P
authors.lastname: Saxena
authors.affiliation: Department of Cardiothoracic Surgery, The Alfred Hospital, Melbourne, Vic, Australia.
authors.forename: David C
authors.initials: DC
authors.lastname: McGiffin
authors.affiliation: Department of Cardiothoracic Surgery, The Alfred Hospital, Melbourne, Vic, Australia.
authors.forename: Silvana
authors.initials: S
authors.lastname: Marasco
authors.affiliation: Department of Advanced Heart Failure/Transplantation, The Alfred Hospital, Melbourne, Vic, Australia.
authors.forename: Angeline S
authors.initials: AS
authors.lastname: Leet
authors.affiliation: Department of Advanced Heart Failure/Transplantation, The Alfred Hospital, Melbourne, Vic, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Bergin
mesh_terms: D006333:Heart Failure / Q000503:physiopathology / Q000601:surgery*; D016027:Heart Transplantation; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D008875:Middle Aged; D014188:Transposition of Great Vessels / Q000503:physiopathology / Q000601:surgery*; D018497:Ventricular Dysfunction, Right / Q000503:physiopathology / Q000601:surgery*
keywords: Pulmonary hypertension; Ventricular assist device; d-Transposition