Bridging to transplantation with a ventricular assist device in giant cell myocarditis was associated with lower 1-year posttransplantation survival compared to no VAD (29% vs 93%; p<0.001).
Cohort (n=39)
Yes
Does the use of ventricular assist devices affect posttransplantation survival in patients with giant cell myocarditis?
While VADs can successfully bridge patients with giant cell myocarditis to transplantation, their posttransplantation survival appears significantly worse compared to those who do not require VAD bridging.
Absolute Event Rate: 29% vs 93%
p-value: p=<0.001
Giant cell myocarditis is a highly lethal disorder characterized by rapidly progressive congestive heart failure. The aim of this study was to describe the clinical course of patients with giant cell myocarditis who received a ventricular assist device. Patients with giant cell myocarditis were identified from the Multicenter Giant cell Myocarditis Registry. Bridging to cardiac transplantation in the giant cell myocarditis patients who received a ventricular assist device was compared with bridging in the general population of heart failure patients, as reported in the literature. Median posttransplantation survival for patients with giant cell myocarditis who received and did not receive ventricular assist devices was calculated by the Kaplan-Meier method and compared with use of the log-rank test. Nine patients with giant cell myocarditis who received ventricular assist devices were identified. Seven patients survived to transplantation, four were alive 30 days posttransplantation, and two survived to 1 year. The rate of successful bridging to transplantation in seven of nine patients (78%) is similar to that reported for other ventricular assist device recipients. Posttransplantation survival of 57% (4 of 7) at 30 days and 29% (2 of 7) at 1 year was significantly lower compared with 93% 1-year survival of the 30 patients with giant cell myocarditis who did not receive ventricular assist devices before transplantation (p<0.001). Ventricular assist devices can be an effective bridge to transplantation for patients with heart failure caused by giant cell myocarditis. Although their posttransplantation survival was poor in our series, a few patients had long-term survival.
Brilakis et al. (Fri,) conducted a cohort in Giant cell myocarditis (n=39). Ventricular assist device vs. No ventricular assist device before transplantation was evaluated on 1-year posttransplantation survival (p=<0.001). Bridging to transplantation with a ventricular assist device in giant cell myocarditis was associated with lower 1-year posttransplantation survival compared to no VAD (29% vs 93%; p<0.001).