Faculty Collaboration Database

HeartWare Ventricular Assist Device Implantation in Patients With Fontan Physiology. Artif Organs 2017 Jan;41(1):40-46

Date

01/18/2017

Pubmed ID

28093805

DOI

10.1111/aor.12852

Scopus ID

2-s2.0-85009761215 (requires institutional sign-in at Scopus site)   33 Citations

Abstract

We aim to describe the clinical course of a series of patients with hypoplastic left heart syndrome and refractory systolic heart failure supported with a HeartWare ventricular assist device (HVAD) following Fontan palliation. This is a retrospective review of three consecutive patients supported with a HVAD following Fontan palliation through February 2016. Data include patient characteristics, operative variables, postimplantation hemodynamic/device parameters, event outcomes, and duration of HVAD support. Patient ages were 11.7, 13.5, and 17.5 years, respectively, at the time of HVAD implant. The duration of HVAD support was 148, 272, and 271 days, respectively, of which 86, 222, and 211 were outpatient days. Inflow cannula position was the morphologic right ventricle with depth adjustment and manipulation of the tricuspid subvalvar apparatus to ensure good inflow. Echocardiographic, hemodynamic, and noninvasive oximetric monitoring resulted in high RPM settings for all patients. Despite various complications, all patients were successfully transplanted and discharged home alive. We present three patients bridged to transplantation using the HVAD following Fontan palliation. We demonstrate potential for durable support with transition to outpatient care while awaiting heart transplantation in a subset of patients status post Fontan surgery.

Author List

Imielski BR, Niebler RA, Kindel SJ, Woods RK

Authors

Steven J. Kindel MD Associate Professor in the Pediatrics department at Medical College of Wisconsin
Robert Niebler MD Professor in the Pediatrics department at Medical College of Wisconsin
Ronald K. Woods MD Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Anticoagulants
Child
Echocardiography
Fontan Procedure
Heart Ventricles
Heart-Assist Devices
Hemodynamics
Humans
Male
Prosthesis Implantation
Retrospective Studies
Treatment Outcome