Left ventricular assist device as destination therapy in cardiac end-stage dystrophinopathies

Midterm results

Gianluigi Perri, Sergio Filippelli, Rachele Adorisio, Roberta Iacobelli, Francesca Giovanna Iodice, Giuseppina Testa, Maria Giovanna Paglietti, Domenico D'Amario, Massimo Massetti, Antonio Amodeo

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Objective: We report our experience with the use of a left ventricular assist device (LVAD) as destination therapy (DT) for the management of patients with cardiac end-stage dystrophinopathies. Methods: From February 2011 to February 2016, 7 patients with dystrophinopathies and dilated cardiomyopathy (DCM) were treated with LVADs at our institution. Median age at surgery was 16.5 years (range, 14.2-23.4 years). All patients were preoperatively evaluated by a multidisciplinary team approach. Results: All patients survived to hospital discharge. The early postoperative course was characterized by abdominal bleeding (1 patient) and retropharyngeal bleeding (1 patient). Because of abdominal or retropharyngeal bleeding, both required postoperative heparin infusion discontinuation for 35 and 33 days, respectively. Among the late complications, 1 child developed osteolysis and infection at the pedestal site of the device, which required surgical displacement; 1 patient required gastrostomy as a result of poor feeding, and another had a cerebral stroke, which was treated with percutaneous thrombus aspiration. The other 2 patients did not show early or late complications. At a median follow-up time of 21.7 months (range, 3-45 months) there have been 3 deaths: 1 patient died of a lung infection after 45 months, 1 died of tracheal bleeding after 29 months, and 1 died of cerebral hemorrhage after 14 months. Conclusions: Our experience indicates that the use of an LVAD as DT in patients with dystrophinopathies with end-stage DCM is feasible, suggesting that it may be suitable as a palliative therapy for the treatment of these patients with no other therapeutic options.

Original languageEnglish
JournalJournal of Thoracic and Cardiovascular Surgery
DOIs
Publication statusAccepted/In press - May 29 2016

Fingerprint

Heart-Assist Devices
Therapeutics
Hemorrhage
Dilated Cardiomyopathy
Palliative Care
Osteolysis
Gastrostomy
Cerebral Hemorrhage
Infection
Heparin
Thrombosis
Stroke

Keywords

  • Duchenne muscolar dystrophy
  • Left ventricular assist device

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Left ventricular assist device as destination therapy in cardiac end-stage dystrophinopathies : Midterm results. / Perri, Gianluigi; Filippelli, Sergio; Adorisio, Rachele; Iacobelli, Roberta; Iodice, Francesca Giovanna; Testa, Giuseppina; Paglietti, Maria Giovanna; D'Amario, Domenico; Massetti, Massimo; Amodeo, Antonio.

In: Journal of Thoracic and Cardiovascular Surgery, 29.05.2016.

Research output: Contribution to journalArticle

Perri, Gianluigi ; Filippelli, Sergio ; Adorisio, Rachele ; Iacobelli, Roberta ; Iodice, Francesca Giovanna ; Testa, Giuseppina ; Paglietti, Maria Giovanna ; D'Amario, Domenico ; Massetti, Massimo ; Amodeo, Antonio. / Left ventricular assist device as destination therapy in cardiac end-stage dystrophinopathies : Midterm results. In: Journal of Thoracic and Cardiovascular Surgery. 2016.
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