No abstract

An almost 3-year-old boy had a residual atrial septal defect after cardiac transplantation. The patient was symptomatic and had arrhythmia and cardiac enlargement. An atrial septal defect occlusion device was employed to close the communication with excellent results. Transcatheter occlusion enabled the patient to avoid further surgery and did not interfere with follow-up endomyocardial biopsies.

With increasing numbers of children surviving complex pathologies to reach adulthood, the adult congenital heart disease population is ever expanding. Often such patients will have undergone multiple sternotomies before developing heart failure requiring advanced heart failure therapies. The late complication of heart failure is not uncommon and presents a therapeutic challenge due to the unusual nature of anatomy and physiology in these patients. Transplantation is often seen as the final staging procedure in adult congenital heart disease, particularly of the patient with single-ventricle physiology. This chapter presents the idiosyncratic issues surrounding organ transplantation in the adult congenital heart disease population.