Infant myocardial recovery with device and surgical repair.

Abstract

A 4-month-old female infant (weight, 6.17 kg; height, 65 cm) presenting with tachypnea and tachycardia, and a left ventricular ejection fraction of 10%, deteriorated on increasing inotropic therapy and mechanical ventilation. Implantation of a centrifugal left ventricular assist device and institution of maximal medical heart failure therapy led to reverse remodeling and discontinuation of device support after 9 days. One week later, after failure to wean from the ventilator and persistence of a severely dyskinetic septum, a ventricular septal aneurysmectomy was done. The patient was extubated 5 days later followed by hospital discharge 11 days post-septal aneurysmectomy. The patient has done well since then with the most recent echocardiogram showing a 65% ejection fraction.