Long-term mechanical circulatory support of an adult patient with down syndrome

Destination therapy with the HeartMate II left-ventricular assist device (Thoratec Corp, Pleasanton, CA) was undertaken in an adult patient with Down syndrome and end-stage heart failure. The patient was bridged to the HeartMate II with extracorporeal membrane oxygenation followed by the Levitronix CentriMag (Levitronix, Waltham, MA). HeartMate II implantation was complicated by coagulopathy. The patient spent 44 postoperative days in hospital and is currently stable in the community. No infections were acquired. Compliance training was delivered primarily to the patient's family. Destination therapy with the HeartMate II may be successfully implemented in eligible, socially supported Down syndrome patients.