Percutaneous closure of patent foramen ovale in a patient presenting arterial hypoxaemia and supported with bi-ventricular assist device

Excerpt

Sir: Due to a shortage of donors, ventricular assist devices (VADs)—left, right or bi-ventricular—have been developed as a bridge to cardiac transplantation for patients with severe congestive heart failure (CHF) [1]. The Berlin Heart VAD is an external implantable device utilising an extracorporeal pump (or “ventricle”) with a compressed air system, which aspirates blood from the atria or ventricles and pumps it through the aorta and/or the pulmonary trunk [1]. In the presence of an inter-atrial communication, i.e. patent foramen ovale (PFO) or atrial septum defect (ASD), a significant right-to-left shunt (RLS) may develop, leading to systemic arterial desaturation [2]. We report the case of a patient with a Berlin Heart bi-ventricular assist device (BiVAD), implanted as a bridge to cardiac transplantation for decompensated CHF, complicated by a severe refractory arterial hypoxemia caused by a RLS via a PFO. …