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

• Published in: Texas Heart Institute journal Vol. 35; no. 3; pp. 340 - 341
• Main Authors: Reverdin, Stephane, Gregoric, Igor D, Kar, Biswajit, Loyalka, Pranav, Bieniarz, Mark C, LeMaire, Scott A, Coselli, Joseph S, Frazier, O H
• Format: Journal Article
• Language: English
• Published: United States Texas Heart Institute 2008
• Subjects: Adult; Aneurysm, Dissecting - surgery; Aortic Aneurysm - surgery; Blood Vessel Prosthesis Implantation; Case Report; 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; heart transplantation; cardiac output/physiology; heart-assist devices; ventricular dysfunction, left/physiopathology/therapy; aortic aneurysm/mortality/surgery; postoperative complications; Aneurysm, dissecting; myocardial infarction/etiology; treatment outcome; shock, cardiogenic/therapy
• ISSN: 0730-2347; 1526-6702

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.