Recovery from anthracycline-induced cardiomyopathy with biventricular assist and valve repairs

A case report and literature review

Yoshiyuki Takami, Naoki Hoshino, Yasuchika Kato, Yusuke Sakurai, Kentaro Amano, Yoshiro Higuchi, Masato Tochii, Michiko Ishida, Hiroshi Ishikawa, Yasushi Takagi, Yukio Ozaki

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Pages (from-to)413-417
Number of pages5
JournalInternational Journal of Artificial Organs
Volume41
Issue number7
DOIs
Publication statusPublished - 01-05-2018

Fingerprint

Anthracyclines
Cardiomyopathies
Heart-Assist Devices
Repair
Chemotherapy
Recovery
Surgery
Oxygenators
Left ventricular assist devices
Cardiogenic Shock
Centrifugal pumps
Balloons
Unloading
Mitral Valve Annuloplasty
Deterioration
Intra-Aortic Balloon Pumping
Tumors
Membrane Oxygenators
Drug Therapy
Cells

All Science Journal Classification (ASJC) codes

  • Bioengineering
  • Medicine (miscellaneous)
  • Biomaterials
  • Biomedical Engineering

Cite this

Takami, Yoshiyuki ; Hoshino, Naoki ; Kato, Yasuchika ; Sakurai, Yusuke ; Amano, Kentaro ; Higuchi, Yoshiro ; Tochii, Masato ; Ishida, Michiko ; Ishikawa, Hiroshi ; Takagi, Yasushi ; Ozaki, Yukio. / Recovery from anthracycline-induced cardiomyopathy with biventricular assist and valve repairs : A case report and literature review. In: International Journal of Artificial Organs. 2018 ; Vol. 41, No. 7. pp. 413-417.
@article{d717666981754e62876bc864f4d7854c,
title = "Recovery from anthracycline-induced cardiomyopathy with biventricular assist and valve repairs: A case report and literature review",
abstract = "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.",
author = "Yoshiyuki Takami and Naoki Hoshino and Yasuchika Kato and Yusuke Sakurai and Kentaro Amano and Yoshiro Higuchi and Masato Tochii and Michiko Ishida and Hiroshi Ishikawa and Yasushi Takagi and Yukio Ozaki",
year = "2018",
month = "5",
day = "1",
doi = "10.1177/0391398818772497",
language = "English",
volume = "41",
pages = "413--417",
journal = "International Journal of Artificial Organs",
issn = "0391-3988",
publisher = "Wichtig Publishing",
number = "7",

}

Takami, Y, Hoshino, N, Kato, Y, Sakurai, Y, Amano, K, Higuchi, Y, Tochii, M, Ishida, M, Ishikawa, H, Takagi, Y & Ozaki, Y 2018, 'Recovery from anthracycline-induced cardiomyopathy with biventricular assist and valve repairs: A case report and literature review', International Journal of Artificial Organs, vol. 41, no. 7, pp. 413-417. https://doi.org/10.1177/0391398818772497

Recovery from anthracycline-induced cardiomyopathy with biventricular assist and valve repairs : A case report and literature review. / Takami, Yoshiyuki; Hoshino, Naoki; Kato, Yasuchika; Sakurai, Yusuke; Amano, Kentaro; Higuchi, Yoshiro; Tochii, Masato; Ishida, Michiko; Ishikawa, Hiroshi; Takagi, Yasushi; Ozaki, Yukio.

In: International Journal of Artificial Organs, Vol. 41, No. 7, 01.05.2018, p. 413-417.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Recovery from anthracycline-induced cardiomyopathy with biventricular assist and valve repairs

T2 - A case report and literature review

AU - Takami, Yoshiyuki

AU - Hoshino, Naoki

AU - Kato, Yasuchika

AU - Sakurai, Yusuke

AU - Amano, Kentaro

AU - Higuchi, Yoshiro

AU - Tochii, Masato

AU - Ishida, Michiko

AU - Ishikawa, Hiroshi

AU - Takagi, Yasushi

AU - Ozaki, Yukio

PY - 2018/5/1

Y1 - 2018/5/1

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=85047659867&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85047659867&partnerID=8YFLogxK

U2 - 10.1177/0391398818772497

DO - 10.1177/0391398818772497

M3 - Article

VL - 41

SP - 413

EP - 417

JO - International Journal of Artificial Organs

JF - International Journal of Artificial Organs

SN - 0391-3988

IS - 7

ER -