A case of left ventricular assist device application for chemotherapy-related cardiomyopathy caused by trastuzumab and a
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CASE REPORT Artificial Heart (Clinical)
A case of left ventricular assist device application for chemotherapy‑related cardiomyopathy caused by trastuzumab and anthracycline Tomohiko Inui1 · Hiroki Kohno1 · Kaoru Matsuura1 · Hideki Ueda1 · Yusaku Tamura1 · Michiko Watanabe1 · Yuichi Inage1 · Yasunori Yakita1 · Goro Matsumiya1 Received: 17 June 2019 / Accepted: 3 December 2019 © The Japanese Society for Artificial Organs 2020
Abstract Left ventricular assist device (LVAD) is an established therapy for patients with severe heart failure. Because the incidence of cardiotoxicity owing to anticancer agents is low, it is difficult to predict the recovery prospects when the cause of heart failure is due to anticancer agents. In this context, cancer patients who present with severe symptoms of heart failure and who fail medical therapy for heart failure may pose a dilemma, especially in countries such as Japan where implantable LVADs are not approved for purposes other than bridging to transplant. Recently, we encountered a 32-year-old woman with chemotherapy-related cardiomyopathy that developed after anticancer treatment using trastuzumab and anthracycline. LVAD therapy was the only option to save the young woman. The patient received an extracorporeal LVAD, her cardiac function gradually recovered while on support, and the device was successfully removed. Keywords Left ventricular assist device (LVAD) · Extracorporeal membrane oxygenation · Chemotherapy-related cardiomyopathy (CCM) · Trastuzumab · Anthracycline · Artificial heart
Introduction Various conditions such as cardiomyopathy and impulse conduction pathway disorder have been associated with the cardiotoxicity of anticancer drugs. Their incidence is reportedly low, but the consequences are often severe and irreversible. Anthracyclines have been used for chemotherapy to treat cancers, such as leukemia and breast cancer. Their long-term use in young patients has caused intractable symptoms related to cumulative toxicity. Anthracyclines are believed to increase cardiotoxicity when used in combination with taxanes and trastuzumab. Trastuzumab alone has also been reported to cause cardiomyopathy, but the disease is often treatable [1]. * Tomohiko Inui [email protected] * Goro Matsumiya [email protected]‑u.jp 1
Department of Cardiovascular Surgery, Chiba University Hospital, 1‑8‑1, Inohana, Chuo‑ku, Chiba 260‑8677, Japan
Here, we report a severe case of chemotherapy-related cardiomyopathy (CCMP) that developed after chemotherapy using trastuzumab and anthracycline. The patient was treated with an extracorporeal left ventricular assist device (LVAD), which was successfully removed after recovery of the left ventricle.
Case report The patient was a 32-year-old woman. At 16 years of age, the patient was administered anthracycline drugs, which included 140 mg/m2 of aclarubicin, 180 mg/m2 of daunorubicin, and 30 mg/m2 of mitoxantrone, for acute myeloid leukemia (AML) and maintained remission thereafter. At 31 years of age, she was diagnosed with left bre
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