Background
Specific aetiologies of cardiomyopathy can significantly impact treatment options
as well as appropriateness and prioritisation for advanced heart failure therapies
such as ventricular assist device (VAD) or orthotopic heart transplantation (OHT).
We reviewed the tissue diagnoses of patients who underwent advanced therapies for
heart failure (HF) to identify diagnostic discrepancies.
Methods
This study presents a retrospective cohort of the aetiology of cardiomyopathy in 118
patients receiving either durable VAD or OHT. Discrepancies between the preoperative
aetiological diagnosis of cardiomyopathy with the pathological diagnosis were recorded.
Echocardiographic and haemodynamic data were reviewed to examine differences in patients
with differing aetiological diagnoses.
Results
Twelve (12) of 118 (12/118) (10.2%) had a pathological diagnosis that was discordant
with pre-surgical diagnosis. The most common missed diagnoses were infiltrative cardiomyopathy
(5) and hypertrophic cardiomyopathy (3). Patients with misidentified aetiology of
cardiomyopathy had smaller left ventricular (LV) dimensions on echocardiography than
patients with dilated cardiomyopathy (5.8±0.9 vs 6.7±1.1 respectively p=0.01).
Conclusions
Most HF patients undergoing VAD and OHT had a correct diagnosis for their heart failure
prior to treatment, but a missed diagnosis at time of intervention (VAD or OHT) was
not uncommon. Smaller LV dimension on echocardiogram in a patient with a non-ischaemic
cardiomyopathy warrants further workup for a more specific aetiology.
Keywords
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Article info
Publication history
Published online: February 12, 2022
Accepted:
December 15,
2021
Received in revised form:
November 1,
2021
Received:
June 4,
2021
Identification
Copyright
© 2022 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.
