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The outcome of patients with peripartum cardiomyopathy and consecutive implantation of a left ventricular assist device
Author(s) -
Djordjevic Ilija,
Merkle Julia,
Eghbalzadeh Kaveh,
Sabashnikov Anton,
Ivanov Borko,
Gummert Jan,
Potapov Evgenij,
Schoenrath Felix,
Meyns Bart,
Özbaran Mustafa,
By Theo M.M.H.,
Wahlers Thorsten,
Zeriouh Mohamed,
Rahmanian Parwis B.
Publication year - 2021
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.15598
Subject(s) - medicine , peripartum cardiomyopathy , cardiogenic shock , ventricular assist device , ejection fraction , heart failure , cardiology , population , heart transplantation , cardiomyopathy , surgery , myocardial infarction , environmental health
Objectives Peripartum cardiomyopathy (PPCM) is a form of systolic heart failure occurring toward the end of pregnancy or in the period after delivery. Lack of myocardial recovery or therapy‐refractory cardiogenic shock are rare complications and left ventricular assist device (LVAD) systems might be used as a life‐saving option. The aim of this study was to investigate outcomes of PPCM patients supported with LVAD, registered in the European Registry for Patients with Mechanical Circulatory Support (EUROMACS). Methods All patients registered in EUROMACS with a primary diagnosis of PPCM were included in this study. Demographic, preoperative, intraoperative, postoperative, and follow‐up data were collected and patients analysed concerning their outcome after initiation of LVAD therapy. Results Between May 2011 and September 2018, 16 patients with PPCM and consecutive LVAD implantation were enrolled into EUROMACS. The median age of the patient population was 31 (26;41) years with a mean left ventricular ejection fraction (LV‐EF) of 15% ± 6%. In‐hospital mortality after LVAD implantation was 6% ( n = 1). One‐year mortality accounted for 13% ( n = 2). Six patients (40%) were transplanted with a median support time of 769 (193;1529) days. Weaning of LVAD support due to ventricular recovery was feasible in 3 (20%) patients. Conclusion In patients with severe PPCM, LVAD therapy is associated with considerably low in‐hospital mortality, potentially allowing bridging to heart transplantation, or left ventricular recovery. Therefore, durable mechanical support should be considered as a treatment option in this, by nature, young and often otherwise healthy patient population.