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Mechanical Support With Impella During Malignant Arrhythmia Ablation: A Case Report on the Growing Trend in the
Adam C Adler1, Ramesh Kodavatiganti
1From the *Department of Anesthesiology, Perioperative and Pain Medicine, Division of Cardiovascular Anesthesiology, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas; and †The Children's Hospital of Philadelphia, Department of Anesthesiology and Critical Care Medicine, Division of Cardiothoracic Anesthesiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
Abstract:
Congenitally corrected transposition of the great arteries is a rare form of congenital heart disease in which the persistence of the right ventricle as the systemic ventricle leads to heart failure, tricuspid valve insufficiency, and arrhythmia. Supraventricular arrhythmias are especially common in these patients. We discuss the anesthetic management of a 33-year-old patient with congenitally corrected transposition of the great arteries who required a ventricular assist device to maintain cardiac output during ablation of supraventricular tachyarrythmia. A witnessed pulseless cardiac arrest and resuscitation during a previous episode of supraventricular tachycardia prompted the elective insertion of the Impella catheter after induction of anesthesia for the ablation procedure.
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