HeartWare ventricular assist device as a bridge to heart transplantation in a patient with congenitally corrected transposition of the great arteries and dextrocardia

Congenitally corrected transposition of the great arteries (ccTGA) is a rare condition with prevalence of <0.5%. Dextrocardia is reported among 20% of them. Among patients with ccTGA, heart failure is a common presentation, especially in the fourth or fifth decade of life and survival is dismal without heart transplantation. A left ventricular assist device (LVAD) is considered for bridge to transplantation if early heart transplantation is not available or as destination therapy for patients ineligible for heart transplant. Our patient had ccTGA and dextrocardia, after which he developed failure of a systemic ventricle and severe systemic atrioventricular valve, subpulmonic atrioventricular valve and aortic valve regurgitation along with paroxysmal atrial fibrillation. A third-generation ventricular assist device HeartWare ventricular assist device (HVAD, HeartWare, Inc., Framingham, MA, USA) was implanted as a bridge to transplantation with concomitant aortic valve replacement with a bioprosthetic valve. There is no prior publication on HVAD implantation in patient having both ccTGA and dextrocardia. Our case report includes the patient's summary and literature review encompassing limited experience of LVADs in patients with ccTGA and dextrocardia.