64-year-old Man Suffering Dilated Phase of HCM Who Died of Intracerebral Hemorrhage Before Exchanging to Implantable LVAD from Extracorporeal

From 17 years old, hypertension was pointed out. At 52 years old the LV function decreased, therefore detailed examinations were performed at a university hospital. But he could not get etiological diagnosis. Antihypertensive treatment was started then. At 58 years old severe heart failure was developed, he was diagnosed as dilated phase of hypertrophic cardiomyopathy. At 63 years old he received the ICD implantation for non-sustained VT attacks, and participated in a cardiac rehabilitation program. At 64 years old he was admitted to another university hospital for severe heart failure and the left lower leg cellulitis. He was transferred to our hospital in order to undergo surgical treatment including extracorporeal LVAD implantation for severe heart failure, severe MR, severe TR, chronic atrial fibrillation, dependence on inotropic agents, renal dysfunction on CHDF, and bacteremia. MVR with bileaflet preservation, LAA closure, full MAZE procedure, TAP, and extracorporeal LVAD implantation were performed with the aim of bridge to decision. LVAD off test was performed on 21st POD. It revealed that removal of the LVAD was impossible. We applied for heart transplantation registration on 50th POD and got the approval immediately. However, before changing to implantable LVAD, he was struck with an intracerebral hemorrhage on 58th POD. He died on 95th POD. The autopsy findings will be presented at the meeting.