Right ventricular hypertrabeculation due to right heart failure after left ventricular assist device implantation.

DESCRIPTION Hypertrabeculation/non-compaction of ventricular myocardium (HVM/NVM) is a cardiomyopathy thought to be caused by arrest of normal embryogenesis of the endocardium and myocardium between the fetal 5th and 8th weeks, resulting in persistence of multiple prominent ventricular trabeculations with deep intertrabecular recesses. The myocardium of the left ventricle is most often affected, but biventricular or right ventricular hypertrabeculation (RVHT) is also possible. RVHT may be associated with congenital heart disease and it has also been reported that RVHT could possibly present as an isolated or acquired disease. Clinical manifestations are highly variable, ranging from no symptoms to disabling congestive heart failure, arrhythmias, systemic thromboemboli and sudden death. A 61-year-old man had a prior medical history of myocardial infarction in 1999 and underwent two-vessel coronary artery bypass grafting in 2000 (left internal mammary artery to the left anterior descendent artery and the first obtuse marginal branch). A biventricular pacemaker with defibrillator (CRT-D) due to advanced chronic heart failure was implanted in February 2010. Owing to the worsening ischaemic cardiomyopathy and recurrent cardiac decompensation, he received a left ventricular assist device (LVAD) as bridge-to-transplant