Survival outcomes of patients with giant cell myocarditis bridged by ventricular assist devices

Giant cell myocarditis is a highly lethal disorder characterized by rapidly progressive congestive heart failure. The aim of this study was to describ e the clinical course of patients with giant cell myocarditis who received a ventricular assist device. Patients with giant cell myocarditis were iden tified from the Multicenter Giant cell Myocarditis Registry. Bridging to ca rdiac transplantation in the giant cell myocarditis patients who received a ventricular assist device was compared with bridging in the general popula tion of heart failure patients, as reported in the literature. Median postt ransplantation survival for patients with giant cell myocarditis who receiv ed and did not receive ventricular assist devices was calculated by the Kap lan-Meier method and compared with use of the log-rank test. Nine patients with giant cell myocarditis who received ventricular assist devices were id entified. Seven patients survived to transplantation, four were alive 30 da ys posttransplantation, and two survived to 1 year. The rate of successful bridging to transplantation in seven of nine patients (78%) is similar to t hat reported for other ventricular assist device recipients. Posttransplant ation survival of 57% (4 of 7) at 30 days and 29% (2 of 7) at 1 year was si gnificantly lower compared with 93% 1-year survival of the 30 patients with giant cell myocarditis who did not receive ventricular assist devices befo re transplantation (p < 0.001). Ventricular assist devices can be an effect ive bridge to transplantation for patients with heart failure caused by gia nt cell myocarditis. Although their posttransplantation survival was poor i n our series, a few patients had long-term survival.