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Successful Venoplasty of Superior Vena Cava Stenosis in a Patient with a Total Artificial Heart after Orthotopic Heart Transplantation due to Primary Graft Failure
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  • Anita Phancao,
  • Aly El Banayosy,
  • Stephen Lee,
  • David Vanhooser,
  • Michael Harper,
  • Douglas Hortsmanshof,
  • James Long,
  • Michael M Koerner
Anita Phancao
University of Miami Department of Medicine
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Aly El Banayosy
INTEGRIS Baptist Medical Center
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Stephen Lee
INTEGRIS Baptist Medical Center
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David Vanhooser
INTEGRIS Baptist Medical Center
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Michael Harper
INTEGRIS Baptist Medical Center
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Douglas Hortsmanshof
INTEGRIS Baptist Medical Center
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James Long
INTEGRIS Baptist Medical Center
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Michael M Koerner
INTEGRIS Baptist Medical Center
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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 (TAH) 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 years old man with a history of non-ischemic cardiomyopathy had received a left ventricular assist device, and then two years later underwent orthotopic heart transplantation using the bicaval anastomosis technique. The post procedural course was complicated by primary graft failure, resulting in the need for the implantation of a TAH. About 5 months after the 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.

Peer review status:Published

19 May 2020Submitted to Journal of Cardiac Surgery
20 May 2020Submission Checks Completed
20 May 2020Assigned to Editor
20 May 2020Reviewer(s) Assigned
02 Jun 2020Review(s) Completed, Editorial Evaluation Pending
02 Jun 2020Editorial Decision: Revise Minor
28 Jun 20201st Revision Received
30 Jun 2020Submission Checks Completed
30 Jun 2020Assigned to Editor
30 Jun 2020Reviewer(s) Assigned
08 Jul 2020Review(s) Completed, Editorial Evaluation Pending
08 Jul 2020Editorial Decision: Accept
19 Jul 2020Published in Journal of Cardiac Surgery. 10.1111/jocs.14877