Intra-aortic balloon counterpulsation in a patient with the failing Fontan circulation

Abstract

We report a 23-year-old patient undergoing functionally univentricular repair who developed cardiac failure due primarily to systemic ventricular dysfunction. The failing Fontan circulation was successfully re-established using intra-aortic balloon counterpulsation. Aortic counterpulsation facilitates recovery of systemic ventricular function, and appears to be a reasonable alternative in select instances of cardiac failure in patients with the Fontan circulation.

Caring for the Critically Ill Adult Congenital Heart Disease Patient

“…As these patients have often undergone several vascular access procedures throughout their lifetimes, scarring around access sites, or chronic occlusions of vessels, can complicate deployment of tMCS. Univentricular systemic ventricle support devices (such as the intra-aortic balloon pump or impella percutaneous ventricular assist device) have both been deployed in patients with congenital heart disease [ 53 – 55 ]. The use of right (or sub-pulmonic) ventricular support devices is still growing in the general ICU population, though it may have particular utility in the ACHD population that often suffers from sub-pulmonic ventricular failure [ 56 – 58 ].…”