Heart Transplantation in Congenital Heart Disease: In Whom to Consider and When?
Figure 1
31-year old patient with tricuspid atresia, atrial and ventricular septal defects, and severe infundibular pulmonary stenosis. He underwent surgical palliation with a Fontan procedure, initially using an atrial to right ventricular conduit, later converted to an atriopulmonary Fontan-Kreutzer-Anastomosis due to conduit failure. After increasing heart failure and 5 cardiac surgeries, he underwent heart transplantation. (a) Chest X-ray with massive cardiac enlargement and the epicardial pacemaker. (b) Subcostal echocardiographic view showing severely dilated right atrium (RA) with spontaneous echocontrast and perihepatic ascites (bold arrow). (c) Axial plane of chest-computed tomogram showing giant right atrium (RA) and normal-sized left ventricle (LV). (d) Coronal plane of chest and abdominal computed tomography showing enlarged right atrium (RA) with connection to the main pulmonary artery (arrow) and hepatomegaly (arrow head).
