Right (systemic) ventricular failure is well described after a Mustard procedure for transposition of the great arteries. Sixty-one percent of patients have been reported to show moderate-to-severe dysfunction of the systemic ventricle, 25 years after repair of transposition of the great arteries by a Mustard procedure. In such cases, heart transplant often seems to be the only option. When severe heart failure with hemodynamic instability develops, the only way to bridge these patients to a transplant is implantation of a mechanical circulatory support system. Because of the special anatomic features of the right ventricle, the implantation procedure can be challenging. Here, we report the case of a patient who underwent a left ventricular assist device implant owing to severe heart failure, 36 years after undergoing a Mustard procedure.
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