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Updated: May 18, 2026
Use of Two Intracorporeal Ventricular Assist Devices As a Total Artificial Heart
Published on: May 11, 2018
Ventricular assist device outflow graft in congenitally corrected transposition of great arteries - a surgical
Prashant N Mohite1, Aron F Popov, Diana Garcia
1Department of Cardiothoracic Transplantation & Mechanical Support, Royal Brompton and Harefield NHS Trust, Harefield Hospital, Hill End Road, Harefield, Middlesex UB9 6JH, UK. drprashantis@rediffmail.com
Insights
Congenitally corrected transposition of the great arteries often leads to heart failure, requiring advanced treatments like heart transplants or mechanical circulatory support. Surgical interventions for this condition present unique challenges due to anatomical variations.
Area of Science:
- Cardiology
- Congenital Heart Disease
- Cardiac Surgery
Background:
- Congenitally corrected transposition of the great arteries (ccTGA) is a complex congenital heart defect.
- Patients often present with diverse clinical manifestations and are diagnosed late.
- The condition frequently progresses to systemic ventricular failure, necessitating advanced therapies.
Observation:
- Surgical repair is common but often leads to long-term complications.
- Systemic ventricular failure is a frequent outcome, requiring heart transplantation or mechanical circulatory assistance.
- Anatomical characteristics of ccTGA, such as the anterior aorta, complicate device implantation.
Findings:
- The anterior and leftward position of the aorta relative to the pulmonary artery in ccTGA creates surgical challenges.
- Outflow graft placement for ventricular assist devices (VADs) can traverse the pulmonary artery, complicating future procedures.
- This anatomical arrangement poses significant difficulties for subsequent surgical interventions and device management.
Implications:
- Understanding these anatomical challenges is crucial for optimizing VAD placement and surgical planning in ccTGA patients.
- Improved surgical techniques and device designs may be needed to mitigate risks associated with ccTGA.
- This highlights the need for specialized care pathways for individuals with complex congenital cardiac anomalies.
Abstract:
Congenitally corrected transposition of the great arteries is a complex congenital cardiac anomaly with a wide spectrum of morphologic features and clinical profiles. Most patients are diagnosed late in their life, undergoes surgical repairs, eventually leading to systemic ventricular failure needing heart transplant or mechanical circulatory assistance. As, aorta is located anterior to and left of the PA (Transposition of great arteries), the outflow graft of ventricular assist device traverse across pulmonary artery to reach aorta which poses challenge during further surgical explorations.
