Brief ReportImplantation of an Atrial Flow Regulator in a Child on Venoarterial Extracorporeal Membrane Oxygenator as a Bridge to Heart Transplant: A Case Report
Section snippets
Case Report
A 12-year-old boy with a 5-year history of severe left ventricular (LV) cardiomyopathy and mitochondrial myopathy with persistent lactic acidosis, was transferred to our pediatric cardiac intensive care unit owing to angina and signs of myocardial ischemia. He had been previously followed in our outpatient clinic and progressive LV dysfunction, dilatation, and fibrosis were noted in serial cardiac magnetic resonance imaging studies (Fig. 1). A transthoracic echocardiogram on admission showed
Discussion
During VA ECMO, it is very important to create optimal cardiac unloading conditions. Different strategies and a variety of interventions such as intra-aortic balloon pump, Impella, atrial septostomy, and LV venting have been proposed. However,1,7, 8, 9, 10, 11, 12 it is unknown the exact degree of LV unloading that is necessary to achieve a balanced hemodynamic setting. Each technique carries significant associated risks, especially when used specifically in children.
The creation of an
Declaration of Competing Interest
Alain Fraisse is consultant and proctor for Abbott and for Occlutech. The other three authors have nothing to declare.
Acknowledgments
All the authors have contributed equally to the case report.
Consent
Consent has been obtained from patient and parents to use the device and publication
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Cited by (6)
Feasibility, Safety, and Efficacy of the Atrial Flow Regulator in Pediatric Patients: A Single-Center Experience
2023, Journal of the Society for Cardiovascular Angiography and InterventionsCatheter-Based Management of Heart Failure: Pathophysiology and Contemporary Data
2022, Interventional Cardiology ClinicsCitation Excerpt :The device has been redesigned and initial trialing is underway. A third device, the atrial flow regulator (AFR, Occlutech, Istanbul, Turkey), is another transseptal leave-behind device that is available in several sizes that have been implemented in several case reports.25–27 The exact role for timing and size of interatrial shunt will serve as areas of exploration.
Stent Implantation Across the Atrial Flow Regulator Device
2024, Pediatric CardiologyFeasibility, safety, and efficacy of Atrial Flow Regulator in children under 10 kg
2023, Catheterization and Cardiovascular InterventionsVersatility of Atrial Flow Regulator Device in Congenital Heart Disease: A Case Series
2023, Pediatric Cardiology
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These authors have contributed equally to this work.