Abstract
Objectives: We report on a 15-year-old patient with failing single ventricle palliation admitted for cardiac transplantation for failing univentricular palliation after tricuspid atresia Ib. So far, a modified Blalock-Taussig shunt and a Glenn anastomosis were performed. Invasive evaluation revealed elevated pulmonary pressure, small pulmonary arteries and extensive pulmonaryarteriovenous fistulas (PAVM) formation in the left lung. Overall, the patient was considered non-transplantable. An alternative treatment strategy with implantation of a Heartware® ventricular assist device together with placement of a systemic shunt to the left lung to promote (1) regression of PAVM by re-establishing hepatic flow to the lung and (2) growth of the pulmonary vasculature, was developed.
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