Thorac Cardiovasc Surg 2010; 58(1): 8-10
DOI: 10.1055/s-0029-1186068
Review

© Georg Thieme Verlag KG Stuttgart · New York

Surgical Treatment of Doxorubicin-Induced Heart Failure

S. Christiansen1
  • 1Department of Cardiac Surgery, Campus Universitätsklinikum Schleswig-Holstein, Lübeck, Germany
Further Information

Publication History

received March 11, 2009

Publication Date:
13 January 2010 (online)

Abstract

Doxorubicin-induced heart failure is a rare, but serious illness and is well-known to be difficult to treat. Prevention strategies have not demonstrated the expected success and unfortunately, this specific type of heart failure does not respond to the usual medical therapies as do other kinds of heart failure. Therefore, surgical procedures may be necessary in some patients. Cardiac transplantation is performed in most cases but this requires cure of the neoplastic disease. This usually requires a recurrence-free interval of several years which is associated with a high attrition rate in these patients due to their cardiac disease. Therefore, ventricular assist devices may be implanted in selected patients as a bridge to transplantation or destination therapy. This review focuses on the surgical options for doxorubicin-induced heart failure and discusses their efficacy as well as their clinical applicability.

References

  • 1 Henderson I C, Frei E. Adriamycin and the heart.  N Engl J Med. 1979;  300 310-312
  • 2 Singal P K, Iliskovic N. Doxorubicin-induced cardiomyopathy.  N Engl J Med. 1998;  339 900-905
  • 3 Steinherz L J, Steinherz P G, Tan C T C, Heller G, Murphy M L. Cardiac toxicity 4 to 20 years after completing anthracycline therapy.  JAMA. 1991;  266 1672-1677
  • 4 Simpson C, Herr H, Courville K A. Concurrent therapies that protect against doxorubicin-induced cardiomyopathy.  Clin J Oncol Nurs. 2004;  8 497-501
  • 5 Keefe D L. Anthracycline-induced cardiomyopathy.  Semin Oncol. 2001;  28 2-7
  • 6 Lefrak E A, Pitha J, Rosenheim S, Gottlieb J A. A clinicopathologic analysis of adriamycin cardiotoxicity.  Cancer. 1973;  32 302-314
  • 7 Tallaj J A, Franco V, Rayburn B K et al. Response of doxorubicin-induced cardiomyopathy to the current management strategy of heart failure.  J Heart Lung Transplant. 2005;  24 2196-2201
  • 8 Iarussi D, Indolfi P, Casale F, Coppolino P, Tedesco M A, DiTullio M. Recent advances in the prevention of anthracycline cardiotoxicity in childhood.  Curr Med Chem. 2001;  13 1649-1660
  • 9 Pacher P, Liaudet L, Bai P L et al. Potent metalloporphyrin peroxynitrite decomposition catalyst protects against the development of doxorubicin-induced cardiac dysfunction.  Circulation. 2003;  107 896-904
  • 10 Siveski-Iliskovic N, Hill M, Chow D A, Singal P K. Probucol protects against adriamycin cardiomyopathy without interfering with its antitumor effect.  Circulation. 1995;  91 10-15
  • 11 Arico M P E, Nespoli L, Pedroni E, Bonetti F, Vigano M, Burgio G R. Heart transplantation in a child with doxorubicin-induced cardiomyopathy.  N Engl J Med. 1988;  319 1353
  • 12 Christiansen S, Autschbach R. Doxorubicin in experimental and clinical heart failure.  Eur J Cardiothorac Surg. 2006;  30 611-616
  • 13 Luthy A, Furrer M, Waser M et al. Orthotopic heart transplantation: an efficient treatment in a young boy with doxorubicin-induced cardiomyopathy.  J Heart Lung Transplant. 1992;  11 815-816
  • 14 Ward K M, Binns H, Chin C, Webber S A, Canter C E, Pahl E. Pediatric heart transplantation for anthracycline cardiomyopathy: cancer recurrence is rare.  J Heart Lung Transplant. 2004;  23 1040-1045
  • 15 Goldstein D J, Seldomridge J A, Addonizio L et al. Orthotopic heart transplantation in patients with treated malignancies.  Am J Cardiol. 1995;  75 968-971
  • 16 Casarotto D, Bottio T, Gambino A, Testolin L, Gerosa G. The last to die is hope: prolonged mechanical circulatory support with a Novacor left ventricular assist device as a bridge to transplantation.  J Thorac Cardiovasc Surg. 2003;  125 417-418
  • 17 Fricker F J, Addonizio L, Bernstein D et al. Heart transplantation in children: indications. Report of the Ad Hoc Subcommittee of the Pediatric Committee of the American Society of Transplantation (AST).  Pediatr Transplant. 1999;  3 333-342
  • 18 Taylor D O, Edwards L B, Aurora P et al. Registry of the International Society for Heart and Lung Transplantation: Twenty-fifth Official Adult Heart Transplant Report–2008.  J Heart Lung Transplant. 2008;  27 943-956
  • 19 Christiansen S, Brose S, Autschbach R. Surgical therapy of end-stage heart failure.  Herz. 2003;  28 380-392
  • 20 Swartz M F, Fink G W, Carhart R L. Use of a biventricular assist device in the treatment of acute doxorubicin-induced cardiotoxicity.  CHF. 2004;  10 197-199
  • 21 Musci M, Loebe M, Grauhan O et al. Heart transplantation for doxorubicin-induced congestive heart failure in children and adolescents.  Transplant Proc. 1997;  29 578-579
  • 22 Simsir S A, Lin S S, Blue L J, Gockerman J P, Russell S D, Milano C A. Left ventricular assist device as destination therapy in doxorubicin-induced cardiomyopathy.  Ann Thorac Surg. 2005;  80 717-719
  • 23 Rose E A, Gelijns A C, Moskowitz A J et al. Long-term use of a left ventricular assist device for end-stage heart failure.  N Engl J Med. 2001;  345 1435-1443
  • 24 Freilich M, Stub D, Esmore D et al. Recovery from anthracycline cardiomyopathy after long-term support with a continuous flow left ventricular assist device.  J Heart Lung Transplant. 2009;  28 101-103
  • 25 Christiansen S, Jahn U R, Meyer J et al. Anticoagulative management of patients requiring left ventricular assist device implantation and suffering from heparin-induced thrombocytopenia type II.  Ann Thorac Surg. 2000;  69 774-777
  • 26 Christiansen S, Van Aken H, Breithardt G, Scheld H H, Hammel D. Successful cardiac transplantation after four cases of DeBakey LVAD failure.  J Heart Lung Transplant. 2002;  21 706-709
  • 27 Oz M C, Gelijns A C, Miller L et al. Left ventricular assist devices as permanent heart failure therapy.  Ann Surg. 2003;  238 577-585
  • 28 Park S J, Tector A, Piccioni W et al. Left ventricular assist devices as destination therapy: a new look at survival.  J Thorac Cardiovasc Surg. 2005;  129 9-17
  • 29 Stevenson L W, Miller L W, Desvigne-Nickens P et al. Left ventricular assist device as destination for patients undergoing intravenous inotropic therapy.  Circulation. 2004;  110 975-981
  • 30 Christiansen S, Klocke A, Autschbach R. Past, present and future of mechanical long-term support in adults.  J Card Surg. 2008;  23 664-676

PD Dr. med. Stefan Christiansen

Department of Cardiac Surgery
Campus Universitätsklinikum Schleswig-Holstein

Campus Lübeck

Ratzeburger Allee 160

23538 Lübeck

Germany

Phone: + 49 45 15 00 21 08

Fax: + 49 45 15 00 20 51

Email: stefanchristiansen@arcor.de

    >