Bou Chaaya Rody G, Simon Joel W, Turrentine Mark, Herrmann Jeremy L, Kay William Aaron, Guglin Maya, Saleem Kashif, Rao Roopa A
Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, United States.
Krannert Institute of Cardiology, Indiana University School of Medicine, Indianapolis, IN, United States.
Front Cardiovasc Med. 2021 Apr 20;8:651496. doi: 10.3389/fcvm.2021.651496. eCollection 2021.
Thirty four-year-old male with history of D-transposition of the great arteries (D-TGA) who underwent Mustard operation at 14 months of age presented in cardiogenic shock secondary to severe systemic right ventricular failure. Catheterization revealed significantly increased pulmonary pressures. Due to the patient's inotrope dependence and prohibitive pulmonary hypertension, he underwent implantation of a Heart Ware HVAD® for systemic RV support. Within 4 months of continuous flow ventricular assist device (VAD) implantation complete normalization of pulmonary vascular resistance (PVR) was achieved. He ultimately underwent orthotopic heart transplantation with favorable outcomes. This is the second report of complete normalization of PVR following VAD implantation into a systemic RV in <4 months. We conducted a thorough literature review to identify Mustard patients that received systemic RV VAD as a bridge to a successful heart transplantation. In this article, we summarize the outcomes and focus on pulmonary hypertension reversibility following VAD implant.
一名34岁男性，有大动脉转位（D-TGA）病史，14个月大时接受了Mustard手术，现因严重的体循环右心室衰竭导致心源性休克。心导管检查显示肺压力显著升高。由于患者对血管活性药物的依赖以及严重的肺动脉高压，他接受了Heart Ware HVAD®植入术以支持体循环右心室。在连续血流心室辅助装置（VAD）植入后的4个月内，肺血管阻力（PVR）完全恢复正常。他最终接受了原位心脏移植，结果良好。这是第二例在不到4个月的时间内将VAD植入体循环右心室后PVR完全恢复正常的报告。我们进行了全面的文献综述，以确定接受体循环右心室VAD作为成功心脏移植桥梁的Mustard手术患者。在本文中，我们总结了结果，并重点关注VAD植入后肺动脉高压的可逆性。
