Left ventricular device implantation for advanced cardiac amyloidosis

The purpose of this study was to analyze the post-hospital outcomes in patients with senile or familial cardiac amyloidosis treated with left ventricular assist device (LVAD) implantation. From December 1, 2008 to May 31, 2012, a total of 9 patients underwent LVAD placement for heart failure secondary to amyloidosis. Prior to LVAD placement, all patients were New York Heart Association (NYHA) Class IV and had a significantly decreased cardiac index (mean 1.93 liters/min/m2 [1.64 to 2.36]). All patients tolerated LVAD implantation well. Post-operatively, 2 patients died prior to hospital discharge. Three patients died since discharge with a median survival of 13.7 months. Four patients remained alive with a follow-up of 16-24 months. The most common adverse event since placement has been gastrointestinal bleeding (3 of 9 patients). Firm conclusions cannot be drawn from our investigation, but the present observations suggest LVAD implantation is technically feasible for patients with severe heart failure due to advanced cardiac amyloidosis.