Abstract：
Ventricular-assist device therapy for small patients with congenital heart disease is challenging due to its complex anatomy and hemodynamics. We describe a 3-year-old patient with heart failure with truncus arteriosus in the palliative stage. The patient underwent palliative right ventricular outflow tract reconstruction following bilateral pulmonary artery banding. At 6 months of age, the patient developed severe truncal valve regurgitation and left ventricular dysfunction. Emergent truncal valve replacement with a mechanical valve was performed, but left ventricular dysfunction persisted. At 3 years of age, the patient developed acute progression of heart failure triggered by influenza infection. The patient was intubated and transferred to our center to determine the indication for heart transplantation. On the second day after admission, signs of multiorgan failure appeared. Emergent ventricular-assist device implantation for both ventricles was performed with truncal valve closure, ventricular septal defect closure, atrial septal defect closure, and re-right ventricular outflow tract reconstruction. The right ventricular-assist device was successfully removed on the seventh postoperative day. Due to the small pulmonary arteries, severe pulmonary stenosis persisted after ventricular-assist device implantation, but it gradually improved with multiple pulmonary angioplasties. The patient was registered in the Japanese organ transplant network and is awaiting a donor organ in a stable condition.
摘要：
针对先天性心脏病小患者的心室辅助装置治疗由于其复杂的解剖结构和血流动力学而具有挑战性。我们描述了一名3岁的心力衰竭患者，该患者处于姑息期。患者在双侧肺动脉绑扎后接受了姑息性右心室流出道重建。在6个月大的时候，患者出现严重的主动脉瓣反流和左心室功能障碍.用机械瓣膜进行了紧急截断瓣膜置换，但左心室功能障碍持续存在.3岁时,患者出现由流感感染引发的急性心力衰竭进展。患者被插管并转移到我们中心以确定心脏移植的适应症。入院后的第二天，出现多器官衰竭的迹象。两个心室的紧急心室辅助装置植入均采用躯干瓣膜闭合术，室间隔缺损闭合术,房间隔缺损封堵术,和右心室流出道重建。术后第七天成功取出右心室辅助装置。由于肺动脉较小,重度肺动脉狭窄在心室辅助装置植入后持续存在,但随着多次肺血管成形术逐渐好转。该患者已在日本器官移植网络中注册，正在等待病情稳定的供体器官。
