Intraoperative transesophageal echocardiography diagnosis of rare source of right ventricular failure after heart transplant

摘要

A 44-year-old male born with D-transposition of the great arteries underwent a Mustard atrial switch procedure after birth (Fig. 1) and eventually developed failure of the morphologic right ventricle (RV). He was admitted for New York Heart Association Class IV heart failure symptoms requiring continuous inotropic therapy and an intraaortic balloon pump to reduce the work of his systemic ventricle, the RV. Heart transplantation was performed, restoring the patient to normal anatomy. Failure of the allograft RV was diagnosed on postoperative day 1 using transthoracic echocardiography (Video 1A and B, see Supplemental Digital Content 1, http://links.lww.com/ AA/A406). No improvement was subsequently seen and he was scheduled for RV assist device (RVAD) placement on postoperative day 10.