[Ventricular assist device implantation as a bridge to cardiac transplantation in two adolescents with end-stage cardiomyopathy and heart failure as a result of anthracycline use].
In a adolescent women aged 15 and 17 years respectively, severe heart failure developed within a few months of anthracycline chemotherapy given for osteosarcoma. In the guidelines of the European Society of Cardiology, malignancy with a remission duration of less than 5 years is an absolute contraindication to cardiac transplantation. Neither patient was eligible to receive a ventricular assist device (VAD) as a bridge to cardiac transplantation in the Netherlands, but they were accepted in Germany. One patient received a cardiac transplant 13 months later and at the last follow-up check she was in good health with a remission of 3 years. The other patient developed bone metastases 6 months after the VAD implantation. Cardiac transplantation was not a treatment option for her. Dose-dependent cardiotoxicity is a serious complication of the use of anthracyclines. In severe heart failure the prognosis is often worse than in adjuvantly treated malignancies like osteosarcoma. VAD may therefore be a valid option for patients with severe heart failure after anthracycline use for a malignancy. In cases of sustained remission VAD may be the bridge to transplantation.
Universitair Medisch Centrum St Radboud, Postbus 9101, 6500 HB Nijmegen.
M
M
Berends
M M J A
MM
van Bokhoven
A
A
van de Luijtgaarden
L B
LB
Bellersen
Q C G
QC
van Hoesel
C M L
CM
van Herpen
D000293:Adolescent; D018943:Anthracyclines / Q000009:adverse effects* / Q000627:therapeutic use; D009202:Cardiomyopathies / Q000139:chemically induced / Q000601:surgery / Q000628:therapy*; D005260:Female; D006333:Heart Failure / Q000139:chemically induced / Q000601:surgery / Q000628:therapy*; D016027:Heart Transplantation; D006353:Heart-Assist Devices; D006801:Humans; D012516:Osteosarcoma / Q000188:drug therapy; D011379:Prognosis; D020127:Recovery of Function; D016276:Ventricular Function / Q000502:physiology
D018943:Anthracyclines
Een steunhart als overbrugging naar een harttransplantatie bij 2 adolescenten met cardiomyopathie en hartfalen in een eindstadium als gevolg van antracyclinegebruik.