Outcomes of Durable Mechanical Circulatory Support in Myocarditis: Analysis of the International Society for Heart and Lung Transplantation Registry for Mechanically Assisted Circulatory Support Registry.

Autor:	Al-Kindi SG; From the Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, Ohio., Xie R; Department of Surgery, The University of Alabama at Birmingham, Birmingham, Alabama., Kirklin JK; Department of Surgery, The University of Alabama at Birmingham, Birmingham, Alabama., Cowger J; Department of Cardiology, Advanced Heart Failure and Transplant Cardiology, Henry Ford Health System, Detroit, Michigan., Oliveira GH; Division of Cardiovascular Sciences, University of South Florida, Tampa, Florida., Krabatsch T; Deutsches Herzzentrum Berlin, Berlin, Germany., Nakatani T; Department of Transplantation, National Cerebral and Cardiovascular Center, Osaka, Japan., Schueler S; Department of Cardiothoracic & Vascular Surgery, Newcastle/Freeman Hospital, UK, Newcastle, United Kingdom., Leet A; Alfred Heart Center, Melbourne, Victoria, Australia., Golstein D; Department of Cardiovascular Surgery, Montefiore Medical Center, Bronx, New York., Elamm CA; From the Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, Ohio.
Jazyk:	angličtina
Zdroj:	ASAIO journal (American Society for Artificial Internal Organs : 1992) [ASAIO J] 2022 Feb 01; Vol. 68 (2), pp. 190-196.
DOI:	10.1097/MAT.0000000000001430
Abstrakt:	Myocarditis can be refractory to medical therapy and require durable mechanical circulatory support (MCS). The characteristics and outcomes of these patients are not known. We identified all patients with clinically-diagnosed or pathology-proven myocarditis who underwent mechanical circulatory support in the International Society for Heart and Lung Transplantation Registry for Mechanically Assisted Circulatory Support registry (2013-2016). The characteristics and outcomes of these patients were compared to those of patients with nonischemic cardiomyopathy (NICM). Out of 14,062 patients in the registry, 180 (1.2%) had myocarditis and 6,602 (46.9%) had NICM. Among patients with myocarditis, duration of heart failure was <1 month in 22%, 1-12 months in 22.6%, and >1 year in 55.4%. Compared with NICM, patients with myocarditis were younger (45 vs. 52 years, P < 0.001) and were more often implanted with Interagency Registry for Mechanically Assisted Circulatory Support profile 1 (30% vs. 15%, P < 0.001). Biventricular mechanical support (biventricular ventricular assist device [BIVAD] or total artificial heart) was implanted more frequently in myocarditis (18% vs. 6.7%, P < 0.001). Overall postimplant survival was not different between myocarditis and NICM (left ventricular assist device: P = 0.27, BIVAD: P = 0.50). The proportion of myocarditis patients that have recovered by 12 months postimplant was significantly higher in myocarditis compared to that of NICM (5% vs. 1.7%, P = 0.0003). Adverse events (bleeding, infection, and neurologic dysfunction) were all lower in the myocarditis than NICM. In conclusion, although myocarditis patients who receive durable MCS are sicker preoperatively with higher needs for biventricular MCS, their overall MCS survival is noninferior to NICM. Patients who received MCS for myocarditis are more likely than NICM to have MCS explanted due to recovery, however, the absolute rates of recovery were low. Competing Interests: Disclosure: J.K.K. serves as the director of the data center for the STS INTERMACS database and received partial salary support from funds paid to the institution. J.C. has received honoraria from Medtronic and Abbot; serves as the vice chair of data studies for IMACS. S.S. has received honorarium from Medtronic as an advisor and proctor. D.G. has received personal fees from Abbot Inc as a Surgical Proctor, Educator, and Consultant. The other authors have no conflicts of interest to report. (Copyright © ASAIO 2021.)
Databáze:	MEDLINE
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