Bi-Atrial Cannulation for Biventricular Assist Device in Children

This article is part of CTSNet’s Guest Editor Series, Insights Into Pediatric Mechanical Circulatory Support. Congenital and pediatric surgeon Dr. Sandeep Sainathan invited accomplished pediatric surgeons from around the world to contribute clinical videos on the surgical aspects of pediatric mechanical circulatory support as a bridge to cardiac transplantation or recovery of cardiac function.  

In this video, the bi-atrial cannulation of a ventricular assist device in patients with restrictive cardiomyopathy is described. Left atrial cannulation in children has the potential to cause right pulmonary vein stenosis and impact the left trail cuff at the time of heart transplantation. The fossa ovalis was used to create an opening in the left atrium, and a ring-enforced polytetrafluoroethylene (PTFE) graft chimney was utilized to drain the left atrium. This approach led to adequate drainage for the left ventricular assist device (LVAD) and did not compromise the right pulmonary veins. 

References

1. K. Maeda, T. Nasirov, V. Yarlagadda, S.A. Hollander, M. Navarathnum, D.N. Rosenthal, S. Chen, C.S. Almond, B.D. Kaufman, O. Reinhartz, J. Murray, J.C. Dykes, Novel Trans-Septal Left Atrial VAD Cannulation Technique for Hypertrophic/Restrictive Cardiomyopathy, The Journal of Heart and Lung Transplantation, Volume 38, Issue 4, Supplement, 2019, Page S479, ISSN 1053-2498, https://doi.org/10.1016/j.healun.2019.01.1218.

Disclaimer

The information and views presented on CTSNet.org represent the views of the authors and contributors of the material and not of CTSNet. Please review our full disclaimer page here.