Iatrogenic ventricular septal defect during right ventricular assist device insertion in congenitally corrected transposition of the great arteries

J Card Surg. 2022 Apr;37(4):1080-1082. doi: 10.1111/jocs.16277. Epub 2022 Jan 27.

Abstract

This case report describes the management of a large iatrogenic ventricular septal defect (VSD) created by the coring device during systemic ventricular assist device (right ventricular assist device [RVAD]) insertion in a 16-year-old patient with congenitally corrected transposition of the great arteries. The VSD was closed by a bovine pericardial patch and the ventriculotomy was extended laterally to relocate the VAD sewing ring. After RVAD implantation, the patient initially remained cyanotic, potentially due to a tiny VSD patch leak with right-to-left shunting. Hypoxia was successfully corrected by rescue nitric oxide infusion and the patient was bridged to transplant after 91 days.

Keywords: congenital; pediatric; surgery; transplant.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Animals
  • Cattle
  • Congenitally Corrected Transposition of the Great Arteries
  • Heart Septal Defects, Ventricular* / etiology
  • Heart Septal Defects, Ventricular* / surgery
  • Heart-Assist Devices* / adverse effects
  • Humans
  • Iatrogenic Disease
  • Transposition of Great Vessels* / complications
  • Transposition of Great Vessels* / surgery