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Double organ transplantation in cardiac amyloidosis.

Gkouziouta, Aggeliki; Farmakis, Dimitrios; Manginas, Athanassios; Sfyrakis, Petros; Saroglou, Georgios; Adamopoulos, Stamatis; Iliodromitis, Efstathios K.
Journal of Cardiovascular Medicine: Post Author Corrections: October 20, 2014
doi: 10.2459/JCM.0000000000000216
Original article: PDF Only

Background: Cardiac amyloidosis, particularly primary or AL amyloidosis, is the most common infiltrative cardiomyopathy and is associated with a poor prognosis. The outcome of cardiac transplantation is generally poor, and almost half of patients die while waiting for the procedure to be done.

Patient: We report here the remarkable case of a 63-year-old man with heart failure caused by AL amyloidosis. After a long course, which included rapid deterioration of preexisting heart failure, cardiac arrest, cardiogenic shock, biventricular assist device support, heart transplantation, renal failure, kidney transplantation and finally a life-threatening H1N1 virus pneumonia, the patient managed not only to survive but also to return fully to his previous demanding duties and lifestyle.

Discussion: Early use of left ventricular or biventricular mechanical circulatory support may be beneficial as a bridge to transplantation in patients with cardiac AL amyloidosis.

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