Left Ventricular Assist Device With a Left Atrial Inflow Cannula for Hypertrophic Cardiomyopathy

Figure 1. Transthoracic Echocardiography Transthoracic echocardiography shows apical 4-chamber (A) and apical 3-chamber (B) views in a patient with advanced heart failure due to hypertrophic cardiomyopathy. These views demonstrate severe left ventricular hypertrophy, small left ventricular cavity, and severe biatrial hypertrophy.

Figure 2. Chest Radiography Chest radiograph (A) shows an enlarged cardiopericardial silhouette, left atrial enlargement, and left atrial appendage enlargement (∗) in a patient with hypertrophic cardiomyopathy. (B) Chest radiography shows appropriate inflow and outflow cannulae positions (black arrows) and a decrease in size of the left atrial appendage following implantation of a left ventricular assist device in the same patient by a transseptal left atrial approach.

Figure 3. Transthoracic Echocardiography, Apical 4-Chamber View Apical 4-chamber transthoracic echocardiography shows a small and hypertrophic left ventricle (purple) and a severely dilated left atrium (blue), and the transseptal left atrial inflow cannula (pink) of a left atrium-to-aorta HeartWare Ventricular Assist Device.

Figure 4. Anatomy of the Heart Explant (A) In situ view of the Gor-Tex graft (housing the inflow cannula) sewn to the atrial septum within the right atrium. (B) Close-up view of the Gor-Tex graft as it traversed the right atrium to join the left atrium at the atrial septum. (C) Explanted heart with ventricular assist device attached (left), and donor heart (right).