Mechanical ventricular assist system required for sustained severe cardiac dysfunction secondary to peripartum cardiomyopathy.
A 29-year old woman developed severe congestive heart failure in the first week after an uneventful full-term delivery. Despite intense medical treatment over the next 6 months, her heart failure symptoms gradually worsened and she eventually developed cardiogenic shock. She successfully underwent the implantation of a left ventricular assist system, but because there was no sign of recovery of ventricular function, she was placed on the waiting list for heart transplantation. After 143 days of support, she suffered from brain hemorrhage, and eventually died after a total of 321 days of left ventricular support. Postmortem examination of the myocardium showed sustained diffuse fibrosis and no inflammatory reaction. This case implies that with severe peripartum cardiomyopathy heart transplantation should be considered without delay even if a mechanical assist system is available.
Monta
Osamu
O
Division of Cardiovascular Surgery, Department of Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
Matsumiya
Goro
G
Fukushima
Norihide
N
Miyamoto
Yuji
Y
Sawa
Yoshiki
Y
Koseki
Masahiro
M
Nakamichi
Itsuko
I
Matsuda
Hikaru
H
D000328:Adult; D009202:Cardiomyopathies / Q000209:etiology*; D017809:Fatal Outcome; D005260:Female; D005355:Fibrosis; D006331:Heart Diseases / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D006333:Heart Failure; D006353:Heart-Assist Devices; D006801:Humans; D049590:Postpartum Period; D011247:Pregnancy; D013997:Time Factors