IATROGENIC VENTRICULAR SEPTAL DEFECT DURING RIGHT VENTRICULAR ASSIST
DEVICE INSERTION IN CONGENITALLY CORRECTED TRANSPOSITION OF THE GREAT
This case report describes the management of a large iatrogenic
ventricular septal defect (VSD) created by the coring device during
systemic ventricular assist device (RVAD) insertion in a 16 year-old
patient with congenitally corrected transposition of the great arteries.
The VSD was closed by bovine pericardial patch and the ventriculotomy
was extended laterally to relocate the VAD sewing ring. After RVAD
implantation, patient initially remained cyanotic, potentially due to a
tiny VSD patch leak with right to left shunting. Hypoxia was
successfully corrected by rescue nitric oxide infusion and patient was
bridged to transplant after 91 days.