Risk of left ventricular assist device as a bridge to heart transplant following postinfarction ventricular septal rupture.

Abstract

Heart transplantation is an effective treatment for end-stage heart failure. However, due to the persistent shortage of donor hearts, many patients die awaiting a transplant. Implantable left ventricular assist devices are now available as a reliable bridge to cardiac transplantation. This report presents a patient with terminal heart failure as a result of a post-myocardial infarction ventricular septal rupture (VSR), who underwent a successful placement of the HeartMate left ventricular assist device (LVAD) and velour patch closure of an apical VSR. Despite this therapy, the patient expired after developing a second VSR, which created a high-flow right-to-left shunt and caused hypoxic irreversible brain injury. We suggest that use of a left ventricular assist device as a bridge to transplantation be approached with extreme caution in a patient with a postinfarction ventricular septal rupture.

• Authors: V R Kshettry, C T Salerno, A J Bank
• Journal: Journal of cardiac surgery (J Card Surg) 1997 Mar-Apr Vol. 12 Issue 2 Pg. 93-7 ISSN: 0886-0440 [Print] United States
• PMID: 9271728 (Publication Type: Case Reports, Journal Article)

Topics

• Echocardiography, Transesophageal
• Fatal Outcome
• Heart Septum (diagnostic imaging)
• Heart Transplantation (methods)
• Heart-Assist Devices (adverse effects)
• Humans
• Male
• Middle Aged
• Myocardial Infarction (complications, diagnostic imaging, surgery)
• Risk Factors
• Rupture, Spontaneous
• Ventricular Dysfunction, Left (diagnostic imaging, etiology, therapy)