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A case of ventricular assist systems as a bridge to myocardial recovery in the therapy of drug treatment resistant peripartum cardiomyopathy
Abstract Number: SUN-37
Abstract Type: Case Report/Case Series
Peripartum cardiomyopathy is an uncommon form of heart failure that happens during the last month of pregnancy or up to five months after giving birth. Ventricular assist device (VAD) is effective therapeutic option for end-stage heart failure patients as a bridge to cardiac transplantation and also has been drawing attention as a new therapeutic strategy that augment myocardial recovery and regeneration while supported by the VAD. In this case we implanted VAD in order to assist cardiac circulation and in anticipate of myocardial recovery. We will report the whole process and details of the course of VAD treatment for drug treatment resistant peripartum cardiomyopathy.
Thirty nine weeks G6P5 44-year-old female patient was admitted to our hospital intensive care unit because of severe peripartum cardiomyopathy (TTE; LVDd/Ds 62/52mm, LVEF 33%). Despite drug treatment with Bromocriptine, intra-aortic balloon pumping (IABP) and percutaneous cardio-pulmonary support, she had a persisting low cardiac index and a left VAD was implanted. And then a right VAD implantation has been needed. In the months following implantation the ventricular systolic function improved. She withdrew from VAD under IABP support on the 40th postoperative day, and withdrew IABP 6th days later. After that, she moved to regular floor with oral treatment of ACE inhibitors, β blockers, and diuretic and Cardiac function improved（TTE; LVDd/Ds=48/33mm,LVEF=61%). About 5 months after the onset of heart failure, patient was discharged home.
We report a patient who received mechanical circulatory support and save her life. We suggest that for the case of drug treatment resistant peripartum cardiomyopathy, VAD support is an effective therapy in order to augment myocardial recovery and regeneration.