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.
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.
Early use of left ventricular or biventricular mechanical circulatory support may be beneficial as a bridge to transplantation in patients with cardiac AL amyloidosis.
aOnassis Cardiac Surgery Center
bSecond Department of Cardiology, Attikon University Hospital
cFirst Department of Internal Medicine, Laiko Hospital
dDepartment of Cardiology, Mediterraneo Hospital, Athens, Greece
Correspondence to Dimitrios Farmakis, MD, PhD, FESC, First Department of Internal Medicine, University of Athens Medical School, Laiko Hospital, Athens, Greece Tel: +30 210 7456432; fax: +30 210 7788830; e-mail: firstname.lastname@example.org
Received 25 December, 2013
Revised 2 August, 2014
Accepted 13 August, 2014