Triple bridge-to-transplant in a case of giant cell myocarditis complicated by human leukocyte antigen sensitization and heparin-induced thrombocytopenia type II.
Bridge-to-bridge experience has documented the feasibility of a switch from short-term to long-term mechanical circulatory support until heart transplant. We describe a case of irreversible cardiogenic shock due to giant cell myocarditis treated consecutively with extracorporal membrane oxygenation, bi-ventricular assist device, and total artificial heart. The postoperative course was complicated by human leukocyte antigen sensitization and heparin-induced thrombocytopenia type II. Our patient successfully underwent heart transplant after 10 months of support and was discharged in good condition. This case illustrates suitable device selection for myocarditis and represents two treatable immunological complications.
Cardiovascular Surgery, Heart Center North Rhine-Westphalia, Bad Oeynhausen, Germany.
Soren
S
Schenk
Latif
L
Arusoglu
Michiel
M
Morshuis
Kazutomo
K
Minami
Peter
P
Sarnowski
Reiner
R
Koerfer
Aly
A
El-Banayosy
D000328:Adult; D006680:HLA Antigens; D016027:Heart Transplantation / Q000276:immunology*; D006493:Heparin / Q000009:adverse effects*; D006650:Histocompatibility Testing; D006801:Humans; D008297:Male; D009205:Myocarditis / Q000150:complications / Q000601:surgery*; D012770:Shock, Cardiogenic / Q000209:etiology / Q000601:surgery*; D013921:Thrombocytopenia / Q000139:chemically induced*
D006680:HLA Antigens; D006493:Heparin