A patient with dilated cardiomyopathy who underwent hemodialysis, hemofiltration and plasma exchange for multiple organ damage and implanted LVAS

Abstract

A teen-ager developed cardiogenic shock and acute heart failure due to dilated cardiomyopathy. Although he had been administered vasopressor and placed on intra-aortic ballon pumping (IABP) at an another hospital, it was difficult to maintain his systemic circulatory dynamics. He was transferred to our hospital to consider the indications for heart transplantation and extra corpored left ventricular assist system (LVAS). Because he could not recover from shock despite the above therapy, we tried to save his life by applying percutaneous cardiopulmonary support (PCPS). Furthermore, he required renal replacement therapy and plasma exchange because of multiple organ failure derived from cardiogenic shock before considering the indications for LVAS. After initiation of hemodialysis, hemofiltration and plasma exchange, renal and hepatic functions were fully recovered. LVAS was implanted on the 25^th day after the onset of cardiogenic shock. He is currently continuing to receive therapy in our hospital without major complications.