Bridge to transplantation with the TandemHeart: bending the indications in a chronic aortic dissection patient with postcardiotomy shock

Tex Heart Inst J. 2008;35(3):340-1.

Abstract

Herein, we report a successful bridge to heart transplantation by use of the TandemHeart percutaneous ventricular assist device (pVAD) in a chronic aortic dissection patient who was experiencing postcardiotomy shock. The patient had undergone an aortocoronary bypass to treat an acute, extensive myocardial infarction that had resulted from severe stenosis of a Cabrol-like graft to the left main coronary artery. The TandemHeart was used successfully, despite classic contraindications for pVAD support. The outcome shows that, in critically ill cardiogenic shock patients, a permissive approach to pVAD use is valuable in screening candidates for long-term ventricular assist device support or for heart transplantation. This case also reveals the validity of direct bridging to transplantation from a pVAD in carefully selected patients.

Keywords: Aneurysm, dissecting; aortic aneurysm/mortality/surgery; cardiac output/physiology; heart transplantation; heart-assist devices; myocardial infarction/etiology; postoperative complications; shock, cardiogenic/therapy; treatment outcome; ventricular dysfunction, left/physiopathology/therapy.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aneurysm, Dissecting / surgery
  • Aortic Aneurysm / surgery
  • Blood Vessel Prosthesis Implantation
  • Coronary Artery Bypass*
  • Coronary Restenosis / surgery*
  • Follow-Up Studies
  • Heart Transplantation*
  • Heart Valve Prosthesis Implantation
  • Heart-Assist Devices*
  • Humans
  • Male
  • Myocardial Infarction / surgery*
  • Postoperative Complications / therapy*
  • Reoperation
  • Shock, Cardiogenic / therapy*