Outcomes of Mechanical Circulatory Support for Giant Cell Myocarditis: A Systematic Review.
Publication/Presentation Date
12-1-2020
Abstract
Treatment of giant cell myocarditis (GCM) can require bridging to orthotopic heart transplantation (OHT) or recovery with mechanical circulatory support (MCS). Since the roles of MCS and immunotherapy are not well-defined in GCM, we sought to analyze outcomes of patients with GCM who required MCS. A systematic search was performed in June 2019 to identify all studies of biopsy-proven GCM requiring MCS after 2009. We identified 27 studies with 43 patients. Patient-level data were extracted for analysis. Median patient age was 45 (interquartile range (IQR): 32-57) years. 42.1% (16/38) were female. 34.9% (15/43) presented in acute heart failure. 20.9% (9/43) presented in cardiogenic shock. Biventricular (BiVAD) MCS was required in 76.7% (33/43) of cases. Of the 62.8% (27/43) of patients who received immunotherapy, 81.5% (22/27) used steroids combined with at least one other immunosuppressant. Cyclosporine was the most common non-steroidal agent, used in 40.7% (11/27) of regimens. Immunosuppression was initiated before MCS in 59.3% (16/27) of cases, after MCS in 29.6% (8/27), and not specified in 11.1% (3/27). Immunosuppression started prior to MCS was associated with significantly better survival than MCS alone (
Volume
9
Issue
12
ISSN
2077-0383
Published In/Presented At
Patel, P. M., Saxena, A., Wood, C. T., O'Malley, T. J., Maynes, E. J., Entwistle, J. W. C., Massey, H. T., Pirlamarla, P. R., Alvarez, R. J., Cooper, L. T., Rame, J. E., & Tchantchaleishvili, V. (2020). Outcomes of Mechanical Circulatory Support for Giant Cell Myocarditis: A Systematic Review. Journal of clinical medicine, 9(12), 3905. https://doi.org/10.3390/jcm9123905
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
33271929
Department(s)
Administration and Leadership
Document Type
Article