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Case Reports
. 2021 Oct;36(10):3944-3947.
doi: 10.1111/jocs.15839. Epub 2021 Jul 22.

Implantation of durable left ventricular assist device in patient with postmyocardial infarction ventricular septal defect

Daniel Hlaváček  1   2 , Martin Pokorný  1 , Peter Ivák  1   2 , Ivan Netuka  1   3 , Ondrej Szárszoi  1   4
Affiliations
Case Reports

Implantation of durable left ventricular assist device in patient with postmyocardial infarction ventricular septal defect

Daniel Hlaváček et al. J Card Surg. 2021 Oct.

Abstract

Ventricular septal defect (VSD) is a severe complication of myocardial infarction (MI) with a high mortality rate. We report a case of a large post-MI VSD treated with percutaneous venoarterial extracorporeal membrane oxygenation (VA-ECMO) to restore hemodynamic stability and to avoid surgery in the acute setting. VSD closure with endoventricular patch and implantation of biventricular assist device (BiVAD) was arranged sixteen days after MI. Because of no signs of myocardial recovery, implantation of durable left ventricular assist device (LVAD) as a bridge to transplant was provided, leaving right ventricular assist device (RVAD) to right ventricle recovery. RVAD was explanted 18 days after durable LVAD placement and the patient was discharged home two months after MI. The use of durable LVAD is a unique solution that can be applied in selected patients with MI-VSD and heart failure.

Keywords: coronary artery disease; mechanical circulatory support; ventricular septal defect.

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