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J Thorac Cardiovasc Surg 2008;136:1082-1083
© 2008 The American Association for Thoracic Surgery

Brief Communication

Hypoxemia after an axial flow pump Jarvik-2000 implantation: Catheter induced

Joonhwa Hong, MD, Soon J. Park, MD*, Sunil V. Mankad, MD, Frank Cetta, Jr., MD, Norman E. Torres, MD, Morgan L. Brown, MD

Mayo Clinic, Rochester, Minnesota

Received for publication October 8, 2007; accepted for publication December 2, 2007.

* Address for reprints: Soon J. Park, MD, Cardiovascular Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905. (Email: park.soon@mayo.edu).

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

Left ventricular assist devices (LVADs) are now being implanted frequently as a bridge therapy to transplant or a destination therapy.1-3Go Device technology is also changing in that nonpulsatile axial flow pumps are being used as frequently as pulsatile pumps at many centers. LVADs are effective in restoring circulation and unloading the left heart. LVAD support could result in a potential problem of right to left shunt through the patent foramen ovale (PFO),4-8Go and the practice of performing transesophageal echocardiography (TEE) looking for PFO at the time of surgery has been well established. We describe an unusual case of significant hypoxemia resulting from a defect in the interatrial septum (IAS) created iatrogenically at the time of an electrophysiologic procedure in a patient who subsequently underwent an axial flow pump implantation.

Clinical Summary

The patient was a 41-year-old man with advanced hypertrophic cardiomyopathy. He had a history of atrial fibrillation and had undergone a transcatheter-based atrioventricular nodal ablation procedure in the past. His condition continued to deteriorate, and he had to be listed for heart transplantation as status 1A supported on 2 inotrope. His echocardiogram demonstrated severe concentric left ventricular hypertrophy . . . [Full Text of this Article]






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