Ventricular Assist Device Implantation in a Patient Congenitally Corrected Transposition of the Great Arteries With I, D, D

先天性矫正型大动脉转位伴I、D、D型畸形患者植入心室辅助装置

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Abstract

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.

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