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Heart Failure After Cavopulmonary Connection: Conversion to Biventricular Circulatory Support
Ryan R Davies1, Jodie L Lantz Apn2, Sara K Mullowney2
1Department of Cardiovascular and Thoracic Surgery, University of Texas Southwestern Medical Center and Children's Health, Dallas, Texas.
The Annals of Thoracic Surgery
|January 22, 2021
Summary
Mechanical circulatory support for patients with superior cavopulmonary connection is complex. Reestablishing caval continuity for biventricular mechanical support improved patient outcomes and organ function in two cases.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Mechanical Circulatory Support
Background:
- Superior cavopulmonary connection (SCPC) presents unique challenges for mechanical circulatory support.
- Factors like elevated pulmonary vascular resistance and complex intracardiac anatomy contribute to support failure.
Observation:
- Two cases of patients with failing SCPC underwent conversion to biventricular mechanical support.
- This conversion involved reestablishing caval continuity to facilitate biventricular support.
Findings:
- Both patients demonstrated recovery of end-organ function and improved participation in rehabilitation.
- The biventricular support approach led to reduced systemic venous pressures and enhanced pulmonary blood flow.
Implications:
- This strategy offers an alternative to traditional single-ventricle support in complex pediatric cardiac cases.
- Reestablishing caval continuity may simplify management compared to total artificial heart or transplant in select patients.
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