Publication Date
2-1-2017
Journal
The Texas Heart Journal
DOI
10.14503/THIJ-15-5628
PMID
28265217
Publication Date(s)
February 2017
Language
English
PMCID
PMC5317364
PubMedCentral® Posted Date
2-1-2017
PubMedCentral® Full Text Version
Post-Print
Published Open-Access
yes
Keywords
Adolescent, cardiomyopathies/chemically induced, cardiovascular surgical procedures/instrumentation/methods, device removal/methods, equipment design, heart failure/therapy, heart-assist devices/utilization, recovery of function, titanium, treatment outcome
Copyright
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
Abstract
We describe the case of a teenage girl with anthracycline-induced cardiomyopathy who received a HeartWare ventricular assist device and underwent successful device explantation after cardiac recovery. During device support, the patient's cardiac function returned to normal. Twelve months after implantation, we explanted the device via repeat median sternotomy. To close the hole in the left ventricular apex and preserve the sewing ring in case future device support is needed, we used a German-manufactured titanium plug, developed specifically for this purpose. To our knowledge, this is the first use of this plug in the United States. The patient recovered uneventfully and was discharged from the hospital on postoperative day 11. Left ventricular biopsy specimens at explantation revealed the resolution of previous degenerative sarcomeric changes. Our patient did well clinically; however, recurrent late anthracycline cardiotoxicity might subsequently cause her cardiac function to deteriorate. In this event, our use of the titanium plug to preserve the left ventricular sewing ring would enable easier device replacement than would other explantation options.