The beauty of brevityTransplantation for Myocarditis: A Controversy Revisited
Section snippets
Case report
A 42-year-old white man presented with symptoms of progressive shortness of breath and lethargy on exertion for 10-months (New York Heart Association [NYHA] functional class III). He was a non-smoker and had no prior medical history. Transthoracic echocardiogram demonstrated global left ventricular (LV) dysfunction with moderate mitral regurgitation. Heart catheterization revealed normal coronary arteries with severely diminished LV systolic function (ejection fraction, 10%). His right heart
Transplantation for Lymphocytic Myocarditis
Lymphocytic myocarditis is considered an indication for VAD placement or transplantation when congestive heart failure is refractory to medical therapy. The incidence of patients undergoing transplantation for myocarditis ranges from 1% to 8%6, 11; however, the incidence may be greater, as the diagnosis is difficult to secure. The benefits of heart transplantation for myocarditis have been challenged, as the reported risk of death following transplantation appears higher than in the general
Summary
Current data suggest that cardiac transplantation for patients with lymphocytic myocarditis is not associated with an increased risk of allograft rejection or death.
In contrast to lymphocytic myocarditis, the data regarding management and outcome of patients with GCM and cardiac sarcoidosis is limited, and optimal strategies have yet to be determined. Despite an approximate 25% risk of histologic recurrence, overall survival of GCM patients post-transplantation is equivalent to survival after
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Cited by (46)
Recurrent Cardiac Sarcoidosis and Giant Cell Myocarditis After Heart Transplant: A Case Report and Systematic Literature Review
2023, American Journal of CardiologyMyocarditis and Pericarditis
2022, Comprehensive PharmacologyViral Myocarditis—Incidence, Diagnosis and Management
2020, Journal of Cardiothoracic and Vascular AnesthesiaIdentifiable Risk Factors and Miscalculations During Listing for Pediatric Heart Transplantation
2018, Seminars in Thoracic and Cardiovascular Surgery: Pediatric Cardiac Surgery AnnualCitation Excerpt :Currently, the survival of these patients is excellent when early support is provided; however, a significant proportion of patients with fulminant myocarditis will require either a destination ventricular assist device or HT.39 It has been suggested that poor outcome following transplant for myocarditis is likely due to the persistence of pretransplant immunologic activity targeting cardiac antigens, predisposing to early graft failure; however, overall survival from myocarditis has been observed to be equal to the survival rate for other transplantation indications.40 The decision to wait for myocardial recovery as opposed to listing for HT can be difficult, thus MCS of cardiovascular collapse from myocarditis with ventricular assist devices should be contemplated.41
Diagnostic Pathology: Cardiovascular
2018, Diagnostic Pathology: Cardiovascular