Trasplante cardiaco en paciente portador de Berlin Heart EXCOR®, con rechazo agudo refractario a tratamiento corticoideo: un reto diagnóstico

Laura Pérez-Gómez, Iris María Esteve-Ruiz, Ana María Campos-Pareja, Diego Rangel-Sousa
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Abstract

We present the case of a 55 year-old patient with severe heart failure secondary to myocarditis with severely depressed ejection fraction, referred to our Hospital for Cardiac pretransplant evaluation. Due to the presence of elevated pulmonary vascular resistance despite optimization of vasodilator medical treatment, an EXCOR® was implanted as a bridge to transplantation. This article aims to highlight the importance of ventricular assist devices to solve long-term contraindication posed severe pulmonary hypertension for heart transplantation. In addition, we will discuss the complications of immune etiology that may arise in the short-medium term and the different diagnostic techniques and treatment options available to address both humoral and cellular rejection to the transplanted organ.

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柏林心脏EXCOR®患者急性皮质激素治疗难治性排斥反应的心脏移植:诊断挑战
我们报告一例55岁的患者,因严重的射血分数降低而继发于心肌炎的严重心力衰竭,转介到我院进行心脏移植前评估。尽管优化了血管扩张药物治疗,但由于肺血管阻力升高,因此植入EXCOR®作为移植的桥梁。本文旨在强调心室辅助装置在解决严重肺动脉高压心脏移植的长期禁忌症中的重要性。此外,我们将讨论在中短期内可能出现的免疫病因并发症,以及不同的诊断技术和治疗方案,以解决对移植器官的体液和细胞排斥。
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