Intracardiac giant cells after left ventricular assist device placement

Area of Science:

• Cardiovascular Pathology
• Transplant Pathology
• Infectious Disease Pathology

Background:

• Multinucleated giant cells in cardiac tissue are associated with conditions like giant cell myocarditis, sarcoidosis, and infections.
• Left ventricular assist devices (LVADs) are used to treat advanced heart failure.

Observation:

• The study reports the first instance of solitary multinucleated giant cells observed in the heart following LVAD placement.
• These findings were identified in an explanted heart 7 months after LVAD surgery, during orthotopic cardiac transplantation.
• A transient Candida glabrata infection was also noted in the patient's history.

Findings:

• The key histologic finding was the presence of scattered, solitary giant cells without accompanying inflammation.
• This pattern is distinct from more aggressive giant cell-related cardiac pathologies.

Implications:

• Recognizing this specific pattern of giant cells is crucial for accurate diagnosis.
• Avoiding misdiagnosis prevents unnecessary concern for recurrent severe cardiac disease in transplanted hearts.