Advertisement
The Journal of Heart and Lung Transplantation
International Society for Heart and Lung Transplantation.

An alternative approach of heartmate 3 implantation in restrictive cardiomyopathy

Published:October 16, 2022DOI:https://doi.org/10.1016/j.healun.2022.10.013
      A 17-year-old 55 kg, 156 cm cachexic male was admitted with cough, abdominal distention, and anasarca. He reported shortness of breath making it difficult to participate in gym class. Examination demonstrated severe hepatomegaly, ascites, tachypnea, and pitting lower extremity edema. Laboratory evaluation showed elevated brain natriuretic peptide, reduced synthetic liver function, and preserved renal function. Echocardiogram and cardiac catherization data was as shown in Table 1. He was started on Milrinone, diuretics and oxygen therapy. Repeat cardiac catheterization with acute vasodilatory testing 1 month later was unchanged. A decision was made to proceed with implantation of a HeartMate 3 left ventricular assist device (LVAD) utilizing the technique described by Maeda et al.
      • Maeda K.
      • Nasirov T.
      • Rosenthal D.
      • Dykes J.
      An alternative approach by heartware ventricular assist device in hypertrophic cardiomyopathy.
      Table 1Preoperative Echocardiography and Catheterization Results
      Echocardiogram
      Function/Form Size measurements Doppler/Flow pattern
      Biventricular systolic function hyperdynamic



      Moderate pericardial effusion
      LV systolic diameter: 2.0 cm

      LV diastolic diameter: 3.4 cm

      LVPW systolic thickness: 1.0 cm

      Septal thickness: 0.67 cm

      Left Atrial systolic diameter: 6.2 cm
      Restrictive inflow pattern across mitral and tricuspid valves with mild insufficiencies.

      Diastolic flow reversal in inferior vena cava.
      Cardiac catheterization
      RVEDP LVEDP PAP PVRi
      17 mm Hg 20 mm Hg Mean 48-50 mm Hg 13 Wood units x m2
      Abbreviations: LV, left ventricle; LVPW, Left ventricle posterior wall; RVEDP, Right ventricle end-diastolic pressure; LVEDP, Left ventricle end-diastolic pressure; PAP, Pulmonary arterial pressure; PVRi, indexed pulmonary vascular resistance.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to The Journal of Heart and Lung Transplantation
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      Reference

        • Maeda K.
        • Nasirov T.
        • Rosenthal D.
        • Dykes J.
        An alternative approach by heartware ventricular assist device in hypertrophic cardiomyopathy.
        Annal Thoracic Surg. 2018; 106 (-11): e231-e232