학술논문

Successful venoplasty of superior vena cava stenosis in a patient with a total artificial heart after orthotopic heart transplantation due to primary graft failure.
Document Type
Article
Source
Journal of Cardiac Surgery. Oct2020, Vol. 35 Issue 10, p2847-2852. 6p. 5 Black and White Photographs.
Subject
*ARTIFICIAL hearts
*VENA cava superior
*HEART transplantation
*SUPERIOR vena cava syndrome
*HEART assist devices
*CARDIOGENIC shock
*SIMULATED patients
*RF values (Chromatography)
Language
ISSN
0886-0440
Abstract
Background: With the limited number of available suitable donor hearts resulting in plateaued numbers of heart transplantations, short‐ and long‐term mechanical circulatory support devices, including the implantation of total artificial hearts (TAHs) are modalities that are increasingly being used as treatment options for patients with end‐stage heart failure. The superior vena cava syndrome has been described in this context in various disease processes. We report successful venoplasty for superior vena cava syndrome in a patient with a TAH. Case Presentation: A 65‐year‐old man with a history of nonischemic cardiomyopathy had received a left ventricular assist device, and then 2 years later, underwent orthotopic heart transplantation using the bicaval anastomosis technique. The postprocedural course was complicated by primary graft failure, resulting in the need for implantation of a TAH. About 5 months after TAH implantation, he started to develop complications such as volume retention, swelling of the upper extremities, and was diagnosed to have a superior vena cava syndrome. The patient underwent a successful venoplasty of his superior vena cava by interventional radiology with resolution of upper body edema, normalization of renal, and liver function. Conclusion: Potential fatal complications caused by catheter or wire entrapment in the right‐sided mechanical valve of a TAH have been reported. We describe a safe method for the treatment of superior vena cava syndrome in patients with TAH. [ABSTRACT FROM AUTHOR]