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J Thorac Cardiovasc Surg 2002;124:400-401
© 2002 The American Association for Thoracic Surgery

Brief Communications

Implantable left ventricular assist device for patients with postinfarction ventricular septal defect

From the Departments of Cardiology and Thoracic and Cardiovascular Surgery, Kaufman Center for Heart Failure, Cleveland Clinic Foundation, Cleveland, Ohio.

Received for publication Nov 26, 2001. Accepted for publication Feb 16, 2002. Address for inquiries: Patrick M. McCarthy, MD, Department of Thoracic and Cardiovascular Surgery, The Cleveland Clinic Foundation, 9500 Euclid Ave, F25, Cleveland, OH 44195 (E-mail: mccartp@ccf.org).

The first 20% of the full text of this article appears below.

The mortality for patients with postinfarction ventricular septal defect (VSD) remains high because of extensive ventricular infarction and cardiogenic shock. ¹ Attempts to bridge patients with VSD to transplantation are complicated by technical difficulties because of necrotic muscle at the site of left ventricular apical cannulation and previously placed patches for VSD repair. We report 2 patients with cardiogenic shock after VSD repair who were bridged to transplant with implantable left ventricular assist device (LVAD) support.

Clinical summaries

Patient 1
A 57-year-old man was transferred 2 days after an anterior wall myocardial infarction with a large left-to-right shunt on an intra-aortic balloon pump and inotropic support. The anterior VSD was repaired with a bovine pericardial patch similar to the technique of David et al. ² The postoperative course was complicated by ongoing cardiogenic shock, despite maximal inotropic and intra-aortic balloon pump support. Despite no residual shunt, the patient had impending multiple organ failure. Seven days after VSD repair, a HeartMate pneumatic . . . [Full Text of this Article]

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