Heart Failure after Cavopulmonary Connection: Conversion to Biventricular Circulatory Support

Ryan R Davies, Jodie Lantz, Sara Mullowney, Ryan Butts, Timothy Pirolli, Robert D B Jaquiss, David Sutcliffe
Annals of Thoracic Surgery 2021 January 19
Mechanical support of patients with superior cavopulmonary connection (SCPC) is challenging; multiple factors contribute to SCPC failure: elevated pulmonary vascular resistance, aorto-pulmonary collateral flow, veno-venous collaterals, ventricular dysfunction, and atrioventricular valve regurgitation. We report 2 cases of conversion from a single ventricle circulation to biventricular mechanical support by re-establishing caval continuity. Both patients have demonstrated recovery of end-organ function and participation in rehabilitation. This method of support results in improved systemic venous pressures and pulmonary blood flow compared with systemic mechanical circulatory support with a cavopulmonary connection and transfers some of the complexity of the transplant to the ventricular assist device implant.

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