Abstract
Background. Implementation of mechanical circulatory support and heart transplantation technologies in paediatric clinical practice is changing approaches of diagnostics and treatment of heart failure (HF) in children. The experience of carrying out such operations in Russian Federation is extremely limited until recently due to absence of legal mechanisms of people declaration of intention recording about postmortal use of organs for transplantation.Clinical Case Description. The rare clinical case of drug-refractory (cardiotonic agents and cardioverter defibrillator implantation) chronic cardiac failure caused by post-myocarditis dilated cardiomyopathy (DCM) which demanded heart transplantation. Postoperative course, specific and non-specific complications, diagnostics and correction approaches are described.Conclusion. In the absence of proper analysis of non-specific slight symptoms myocarditis can progress to DCM and be complicated by development of refractory HF. The only method of sustaining child’s life in such case is heart transplantation which is connected with high risk of numerous and life-threatening complications.
Highlights
Implementation of mechanical circulatory support and heart transplantation technologies in paediatric clinical practice is changing approaches of diagnostics and treatment of heart failure (HF) in children
The rare clinical case of drug-refractory chronic cardiac failure caused by post-myocarditis dilated cardiomyopathy (DCM) which demanded heart transplantation
In the absence of proper analysis of non-specific slight symptoms myocarditis can progress to DCM and be complicated by development of refractory HF
Summary
Внедрение в клиническую практику устройств механической поддержки кровообращения и технологий трансплантации сердца у детей меняет подходы к диагностике и терапии сердечной недостаточности (СН) у детей. Н. Трансплантация сердца как метод лечения рефрактерной сердечной недостаточности вследствие постмиокардитической дилатационной кардиомиопатии: клинический случай. Расширение показаний для трансплантации сердца обусловлено высокой летальностью больных в этой группе: в течение первого года наблюдения умирает 26–30% детей с дилатационной кардиомиопатией, в течение 5 лет — 35–40%, главным образом от хронической СН, тромбоэмболии или нарушений ритма сердца [2, 7, 15]. Цель представленного ниже клинического наблюдения — продемонстрировать малосимптомное быстропрогрессирующее течение постмиокардитической кардиомиопатии, осложненной рефрактерной СН, потребовавшей трансплантации сердца у ребенка. Heart Transplantation as a Treatment Method for Refractory Heart Failure due to Post-myocarditis Dilated Cardiomyopathy: a Clinical Case
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