Sun Yongfeng, Yang Yuehang, Zhang Jing, Shi Jiawei, Zhou Cheng
From the Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
ASAIO J. 2025 Jun 1;71(6):e97-e99. doi: 10.1097/MAT.0000000000002388. Epub 2025 Feb 28.
Congenitally corrected transposition of the great arteries (ccTGA) is a rare congenital heart anomaly that often leads to systemic heart failure, necessitating mechanical circulatory support or transplantation. We report a case of a 54 year old male diagnosed with dextrocardia and ccTGA (I, D, D), who had been suffering from congestive heart failure for over 7 years. Despite receiving intensive treatment, his condition deteriorated. Preoperative evaluation revealed significant systemic right ventricular dysfunction with severe valvular regurgitation and pulmonary hypertension. The surgical approach included tricuspid and aortic bioprosthetic valve replacement, mitral valve annuloplasty, and right thoracic ventricular assist device (VAD) implantation. The patient recovered well postoperatively and was discharged on postoperative day 39 with New York Heart Association (NYHA) class I. This case demonstrates the feasibility of using VAD in right heart ccTGA as a bridge to transplantation or destination therapy, emphasizing the importance of meticulous preoperative planning and intraoperative management for successful outcomes.
先天性矫正型大动脉转位(ccTGA)是一种罕见的先天性心脏畸形,常导致体循环心力衰竭,需要机械循环支持或移植。我们报告一例54岁男性患者,诊断为右位心和ccTGA(I,D,D),患有充血性心力衰竭超过7年。尽管接受了强化治疗,但其病情仍恶化。术前评估显示存在严重的体循环右心室功能障碍,伴有严重的瓣膜反流和肺动脉高压。手术方法包括三尖瓣和主动脉生物瓣膜置换、二尖瓣瓣环成形术以及右胸心室辅助装置(VAD)植入。患者术后恢复良好,术后第39天以纽约心脏协会(NYHA)I级出院。该病例证明了在右心ccTGA中使用VAD作为移植桥梁或终末期治疗的可行性,强调了细致的术前规划和术中管理对成功结果的重要性。