BIVENTRICULAR ASSIST DEVICE AS A BRIDGE TO CARDIAC TRANSPLANTATION INTHE TREATMENT OF PERIPARTUM CARDIOMYOPATHY

Peripartum cardiomyopathy is an unexpected complication of the puerper ium with a high mortality rate, Appropriate therapy requires accurate identification of this disease, which is frequently difficult in a pat ient who has been previously healthy, Medical therapy using alteration of intravascular volume (to optimize ventricular preload), the additi on of inotropic agents (to correct ventricular function), and intra-ao rtic balloon counterpulsation (to improve afterload reduction) is the first line of therapy, Surgical therapy, involving cardiac transplanta tion, is the ultimate treatment, This therapeutic modality, however, i s Limited by a lack of available organs for transplant, The developmen t of devices to be used as a ''bridge'' is gaining acceptance and use as a pretransplantation procedure, This use may be considered particul arly fundamental in otherwise healthy young women with peripartum card iomyopathy, These patients frequently can have almost complete recover y and rehabilitation, We report the case of a young woman with peripar tum cardiomyopathy who had a favorable outcome, We performed medical a nd surgical therapy, insertion of a temporary ''bridge'' device, and u ltimately cardiac transplantation.