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Ventricular assist device support as a bridge to heart transplantation in patients with giant cell myocarditis

Lindsay K Murray1, Jose González-Costello, Samual N Jonas

  • 1Department of Medicine, Columbia University, New York, NY 10032, USA.

European Journal of Heart Failure
|January 24, 2012
PubMed

Insights

Ventricular assist devices (VADs) offer a viable bridge to heart transplantation for patients with end-stage giant cell myocarditis (GCM). This approach leads to good survival rates post-transplant, though careful immunosuppression is needed.

Area of Science:

  • Cardiology
  • Transplantation Immunology

Background:

  • Giant cell myocarditis (GCM) is a severe heart condition with a poor prognosis.
  • Many GCM patients require advanced therapies like heart transplantation.

Purpose of the Study:

  • To evaluate the effectiveness of ventricular assist devices (VADs) as a bridge to orthotopic heart transplantation (OHT) for GCM patients.
  • To assess the long-term outcomes of GCM patients undergoing VAD support and subsequent OHT.

Main Methods:

  • Retrospective analysis of GCM patients who received VADs.
  • Diagnosis confirmed via endomyocardial or explanted heart biopsy.
  • Six patients received VADs (biventricular or LVAD) and were bridged to OHT.

Main Results:

  • Four of six VAD-supported patients were successfully bridged to OHT and remain alive with a mean follow-up of 5.7 years.
  • Two patients died while on VAD support.
  • Post-OHT, two patients experienced recurrent GCM (treated with immunosuppression), and three had high-grade rejection. Cardiac function was preserved in all survivors.

Conclusions:

  • VADs can successfully bridge patients with end-stage GCM to OHT, resulting in favorable post-transplant survival.
  • Further research is needed to optimize immunosuppressive strategies to manage rejection and GCM recurrence post-OHT.
Abstract

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