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Coil Embolization and Left Ventricular Assist Device After Arterial Switch Operation.
Makoto Nakamura1, Kazuyoshi Kanno1, Masahiko Nishioka1
1Department of Pediatric Cardiovascular Surgery, Okinawa Prefectural Nanbu Medical Center & Children's Medical Center, Okinawa, Japan.
The Annals of Thoracic Surgery
|March 23, 2021
Summary
Symptomatic aortopulmonary collateral arteries after arterial switch surgery can cause severe complications. Coil embolization effectively treated these arteries, leading to hemodynamic improvement and an uneventful recovery.
Area of Science:
- Cardiovascular Surgery
- Pediatric Cardiology
- Interventional Cardiology
Background:
- Aortopulmonary collateral arteries (APCAs) are common in patients with transposition of the great arteries (TGA) post-catheterization.
- While often asymptomatic, APCAs can lead to heart failure or pulmonary hemorrhage after arterial switch operation (ASO).
Observation:
- This report details a case of symptomatic APCAs in an infant following ASO.
- The infant developed severe mitral regurgitation and left atrial hypertension, requiring mechanical circulatory support with a centrifugal pump and left ventricular assist device.
Findings:
- Emergent coil embolization of the symptomatic APCAs was performed.
- Hemodynamic parameters significantly improved immediately after the embolization procedure.
Implications:
- Coil embolization is an effective treatment for symptomatic APCAs post-ASO, resolving hemodynamic instability.
- This intervention facilitated an uncomplicated postoperative course and successful hospital discharge.
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