A Ventricular Assist Device Vertically Placed to the Systemic Right Ventricle in a Patient With Congenitally Corrected Transposition of the Great Arteries and Mesocardia

Abstract

We report a case of 38-year-old female with congenitally corrected transposition of the great arteries and ventricular septum defect. She had undergone physiological repair 28 years ago and closure of residual ventricular septum defect 19 years previously. She was listed for heart transplantation one year ago due to severe systemic right ventricular dysfunction, readmitted two months back due to worsening heart failure, and became inotropic support dependent. Implantation of a ventricular assist device was indicated as a bridge to heart transplant. A standard implantation method from the apex of the heart to the systemic right ventricle was challenging due to mesocardia and longitudinal configuration of the right ventricle. Therefore, under transesophageal echocardiogram guidance, the 3rd generation ventricular assist device was vertically placed from the diaphragmatic surface towards the aortic valve. The postoperative course was uneventful, and the patient was waiting for heart transplantation as an outpatient.