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Advanced Heart Failure Secondary to Chagas Cardiomyopathy: A Case of Successful Left Ventricular Assist Device

Sonal Kumar1, Carlos Rincon-Vazquez2, Patricia Ward3

  • 1Surgery, Ross University School of Medicine, Miramar, USA.

Cureus
|July 1, 2025
PubMed

Insights

Left ventricular assist device (LVAD) offers a life-extending option for patients with Chagas cardiomyopathy and heart failure. This approach is vital for non-transplant candidates, highlighting multidisciplinary care needs.

Area of Science:

  • Cardiology
  • Infectious Diseases

Background:

  • Chagas cardiomyopathy is a significant cause of nonischemic heart failure in endemic regions.
  • This case involves a patient with severe heart failure due to Chagas disease, hypertension, and hyperlipidemia.

Observation:

  • The patient presented with advanced heart failure (LVEF 10%) refractory to medical therapy and implantable cardioverter-defibrillator (ICD).
  • He developed cardiogenic shock, with right heart catheterization revealing severely reduced cardiac output and elevated wedge pressure.

Findings:

  • The patient was deemed ineligible for heart transplantation but suitable for a left ventricular assist device (LVAD).
  • Following infectious disease clearance and prophylaxis for *Trypanosoma cruzi*, LVAD implantation was successful.
  • One-month follow-up demonstrated clinical stability, symptom improvement, and adherence to medical therapy.

Implications:

  • LVAD implantation serves as a crucial life-extending therapy for select patients with Chagas cardiomyopathy who are not candidates for heart transplantation.
  • Multidisciplinary care is essential for managing the complex cardiac and infectious aspects of Chagas disease.

Keywords:
acute-on-chronic heart failureadvanced heart failurecardiogenic shockchagas cardiomyopathyejection fractionheart failureimplantable cardioverter-defibrillatorleft ventricular assist deviceright heart catheterizationtrypanosoma cruzi

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