BackgroundCardiac amyloidosis, particularly primary or AL amyloidosis,
is the most common infiltrative cardiomyopathy and is associated with a
poor prognosis. The outcome of cardiac transplantation is generally
poor, and almost half of patients die while waiting for the procedure to
be done.PatientWe report here the remarkable case of a 63-year-old man
with heart failure caused by AL amyloidosis. After a long course, which
included rapid deterioration of preexisting heart failure, cardiac
arrest, cardiogenic shock, biventricular assist device support, heart
transplantation, renal failure, kidney transplantation and finally a
life-threatening H1N1 virus pneumonia, the patient managed not only to
survive but also to return fully to his previous demanding duties and
lifestyle.DiscussionEarly use of left ventricular or biventricular
mechanical circulatory support may be beneficial as a bridge to
transplantation in patients with cardiac AL amyloidosis
