Total circulatory support with an LVAD in an adolescent with a previous Fontan procedure

Abstract

We report the case of a 14-year-old boy who developed ischemic contracture of the heart after open heart surgery to correct complex congenital heart disease. Because he had no cardiac function, an extracorporeal, continuous-flow device was used to support him until he was transferred to our institution. Shortly after his arrival, an implantable, long-term left ventricular assist device was implanted. The univentricular pump provided total cardiac support for this critically ill patient. After normalization of end-organ function, the patient underwent successful orthotopic cardiac transplantation.

Fig. 1 A) The modified Fontan procedure. B) The nonfunctional right ventricle as seen through the ventricular cavity. C) After complete mitral valve excision, a pouch is constructed from the remaining viable myocardium and the left atrium to serve as a reservoir for the inlet cannula. D) The completed left ventricular assist device implantation. Drawings by Bill Andrews.