Document Detail


Recovery of ventricular function with a left ventricular axial pump in a patient with end-stage toxic cardiomyopathy not a candidate for heart transplantation: first experience in Spain.
MedLine Citation:
PMID:  19715885     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Toxic cardiomyopathies are rare and the most frequent cause are anthracycline compounds. Early acute toxicity can be reversible, but at present the only effective therapy for late end-stage anthracycline cardiomyopathy seems to be a heart transplantation. Currently, this transplantation is contraindicated in cases of cancer, at least during the first 4 or 5 years. Recently, implantable axial pumps have shown good results and are used with increasing frequency as destination therapy. METHODS: We present a case of end-stage heart failure due to a toxic cardiomyopathy after a bilateral breast cancer treated with resection and chemotherapy (doxorubicin and trastuzumab). Ejection fraction was 23% with dobutamine. A left ventricular axial pump (Incor) was implanted. RESULTS: The immediate postoperative course was uneventful. The left ventricular function improved and on the fourth month the ejection fraction was 55%. On postoperative day 135, the pump was explanted. After 1.5 years, the patient is doing well, with an ejection fraction of 57%. CONCLUSION: This is the first application of an implantable axial pump in Spain. Although toxic cardiomyopathies are rare, in cases of late end-stage left ventricular failure and when the heart transplantation is contraindicated, the implantation of an axial pump can be the solution. The results in previous cases are unknown, although it is possible, as in our case.
Authors:
E Castells; J Roca; A Miralles; N Manito; D Ortiz; J Gonzalez; J Granados; M Benito; M Rabasa; F S'braga; J Toscano; D Toral; A L??pez; C Fontanillas
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Transplantation proceedings     Volume:  41     ISSN:  1873-2623     ISO Abbreviation:  Transplant. Proc.     Publication Date:    2009 Jul-Aug
Date Detail:
Created Date:  2009-08-31     Completed Date:  2010-01-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0243532     Medline TA:  Transplant Proc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2237-9     Citation Subset:  IM    
Affiliation:
Department of Cardiac Surgery, Bellvitge University Hospital IDIBELL, Hospitalet de Llobregat, Barcelona, Spain. castellscuch@bellvitgehospital.cat
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MeSH Terms
Descriptor/Qualifier:
Adult
Anthracyclines / toxicity
Breast Neoplasms / complications
Cardiomyopathies / chemically induced,  complications*,  pathology,  surgery
Disease Progression
Female
Heart Transplantation / statistics & numerical data*
Heart-Assist Devices*
Humans
Patient Selection
Prostheses and Implants
Spain
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anthracyclines

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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