Management of new-onset congestive heart failure in a patient with complex congenital heart disease.

The authors describe a 37-year-old African American female patient with congenital tricuspid stenosis, a secundum atrial septal defect, a ventricular septal defect, and subpulmonic stenosis whose only surgical intervention was a Glenn shunt procedure at the age of 11. She had been in reasonably good health for 26 years, but developed congestive heart failure. Her deteriorating clinical course was difficult to manage with only medical treatment, and cardiopulmonary transplantation is now being considered for the management of her complicated clinical condition.