Mechanical ventricular assistance in heart failure: pathology of the cardiac apex removed during device implantation

Cazes, Aurélie; Van Huyen, Jean-Paul Duong; Fornes, Paul; Amrein, Catherine; Guillemain, Romain; Grinda, Jean-Michel; Bruneval, Patrick

doi:10.1016/j.carpath.2008.10.013

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Volume 19, Issue 2 , Pages 112-116, March 2010

Mechanical ventricular assistance in heart failure: pathology of the cardiac apex removed during device implantation

Aurélie Cazes
- Department of Pathology, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
- Université Paris Descartes, Paris, France
- Corresponding author. Service d'Anatomie Pathologique, Hôpital Européen Georges Pompidou, 75015-Paris, France. Tel.: +33 1 56 09 38 86; fax: +33 1 56 09 38 89.
Jean-Paul Duong Van Huyen
- Department of Pathology, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
- Université Paris Descartes, Paris, France
Paul Fornes
- Department of Pathology, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
- Université Paris Descartes, Paris, France
Catherine Amrein
- Cardiac Transplantation Unit, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
Romain Guillemain
- Cardiac Transplantation Unit, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
Jean-Michel Grinda
- Department of Cardiac Surgery, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
Patrick Bruneval
- Department of Pathology, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
- Université Paris Descartes, Paris, France

Received 21 June 2008; received in revised form 17 September 2008; accepted 28 October 2008. published online 15 January 2009.

Abstract

Background

Ventricular assistance device (VAD) implantation provides large ventricular core biopsies available for pathological assessment. We present here the pathological data from 60 apex removed during a 7-year-period in a single institution.

Results

The most frequent specific lesions were ischemic myocardial damage. Nonspecific pathological features were quite as frequently observed and correspond either to dilated cardiomyopathies, chronic ischemic cardiopathies, or miscellaneous conditions. Myocarditis represented 10 out of the 60 cases. The pathological data changed the clinical diagnosis in four cases: 1 case of juvenile hemochromatosis featuring as myocarditis and three cases of myocarditis featuring as dilated cardiomyopathies.

Conclusion

Apex pathological analysis provides definite diagnosis and contributes to determine the cases which the cardiac disease have a possibility to recover under VAD.

Keywords: Ventricular assistance devices, Myocarditis, Cardiomyopathies, Heart failure therapy