MISC

2018年5月1日

Recovery from anthracycline-induced cardiomyopathy with biventricular assist and valve repairs: A case report and literature review

International Journal of Artificial Organs
  • Yoshiyuki Takami
  • Naoki Hoshino
  • Yasuchika Kato
  • Yusuke Sakurai
  • Kentaro Amano
  • Yoshiro Higuchi
  • Masato Tochii
  • Michiko Ishida
  • Hiroshi Ishikawa
  • Yasushi Takagi
  • Yukio Ozaki
  • 全て表示

41
開始ページ
413
終了ページ
417
DOI
10.1177/0391398818772497

© The Author(s) 2018. Introduction: Ventricular assist device is used in the patients with severe heart failure due to cardiotoxicity of anthracyclines, which are widely used chemotherapeutic agents for a wide range of malignant tumors. However, recovery of cardiac function is rare. Methods: We present the clinical course of a 43-year-old woman in remission from diffuse large B-cell lymphoma after the chemotherapy including anthracyclines, who presented in cardiogenic shock 8 months after the end of chemotherapy. Results: The patient was initially treated with intra-aortic balloon pumping, followed by conversion to left ventricular assist device with an Abiomed AB5000 (Abiomed, Inc, Danvers, MA) and right ventricular assist device with a centrifugal pump and a membrane oxygenator, in addition to tricuspid annuloplasty, due to rapid deterioration to cardiogenic shock. With intensive medical treatments during biventricular support, her cardiac and respiratory functions gradually improved, although moderate mitral regurgitation persisted despite of left ventricular unloading. At 64 days of biventricular support, she underwent mitral valve annuloplasty to correct regurgitation under cardiopulmonary bypass. She was consequently weaned from biventricular assist successfully 8 days after mitral surgery (72 days of biventricular support). The patient discharged uneventfully from our hospital and survives at home 12 months after weaning from the ventricular assist devices. Conclusion: Our case and the literature review highlight potential usefulness of aggressive mechanical biventricular support for cardiac recovery in patients with anthracycline-induced cardiomyopathy. Additional valve surgery and neurohormonal medications may be also promising in such patients with cancer, who are contraindicated for heart transplantation.

リンク情報
DOI
https://doi.org/10.1177/0391398818772497
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/29806528
URL
https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85047659867&origin=inward
ID情報
  • DOI : 10.1177/0391398818772497
  • ISSN : 0391-3988
  • PubMed ID : 29806528
  • SCOPUS ID : 85047659867

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