Left ventricular circulatory support as bridge to heart transplantation in Chagas' disease cardiomyopathy.
This study was performed to assess the safety and feasibility of the implantation of ventricular assist devices (VADs) as a bridge to heart transplantation in patients with advanced biventricular failure due to Chagas' disease. Six patients were submitted to paracorporeal left VAD implantation, while right ventricular dysfunction was managed clinically. The mean time of circulatory support was 27 days. Two patients were bridged to heart transplantation successfully, while the other four patients died under assistance with complications that correlated with the final situation of multiple organ failure. Nevertheless, persistent right ventricular dysfunction was observed only in one patient who survived more than 15 days, despite the general significant preoperative compromise of the right ventricle. This paradoxical observation indicates that left VAD implantation may be regarded as a valuable treatment option for patients with Chagas' disease cardiomyopathy who evolve with decompensated heart failure or cardiogenic shock.
Moreira
Luiz Felipe P
LF
Cardiothoracic Surgery Division of the Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil. dcimoreira@incor.usp.br
Galantier
João
J
Benício
Anderson
A
Leirner
Adolfo A
AA
Cestari
Idágene A
IA
Stolf
Noedir A G
NA
D000328:Adult; D001794:Blood Pressure / Q000502:physiology; D016026:Bone Marrow Transplantation; D002302:Cardiac Output / Q000502:physiology; D002598:Chagas Cardiomyopathy / Q000469:parasitology / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006333:Heart Failure / Q000469:parasitology / Q000503:physiopathology / Q000628:therapy*; D006334:Heart Function Tests; D016027:Heart Transplantation; D006353:Heart-Assist Devices / Q000009:adverse effects; D006801:Humans; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000469:parasitology / Q000503:physiopathology / Q000601:surgery*; D018497:Ventricular Dysfunction, Right / Q000188:drug therapy / Q000469:parasitology / Q000503:physiopathology