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Primary cardiac sarcomas often strike young, healthy patients and tend to have a dismal prognosis. Because of limited experience, the heterogeneous nature of cardiac sarcomas and different treatment results of patients with malignant primary tumours of the heart, the role of heart transplantation should be weighed on a case-by-case basis. [ABSTRACT FROM PUBLISHER]

A correction to the article "Single-centre experience of 85 patients with a continuous-flow left ventricular assist device: clinical practice and outcome after extended support" is presented.

OBJECTIVES We evaluated our single-centre clinical experience with the HeartMate II (HM II) left ventricular assist device (LVAD) as a bridge to transplantation (BTT) in end-stage heart failure (HF) patients. METHODS Survival rates, echocardiographic parameters, laboratory values and adverse events of 85 consecutive patients supported with a HM II were evaluated. RESULTS Overall, mean age was 45 ± 13 years, 62 (73%) were male and non-ischaemic dilatated cardiomyopathy was present in 60 (71%) patients. The median duration of mechanical support was 387 days (IQR 150–600), with a range of 1–1835 days. The 6-month, 1-, 2-, 3- and 4-year survival rates during HM II LVAD support were 85, 81, 76, 76 and 68%, respectively. Echocardiographic parameters demonstrated effective left ventricular unloading, while laboratory results reflected adequate organ perfusion. However, HM II support was associated with adverse events, such as infections in 42 patients (49%; 0.67 events/patient-year), cardiac arrhythmia in 44 (52%; 0.86 events/patient-year), bleeding complications in 32 (38%; 0.43 events/patient-year) and neurological dysfunction in 17 (20%; 0.19 events/patient-year). CONCLUSIONS In view of the increasing shortage of donor hearts, HM II LVAD support may be considered a life-saving treatment in end-stage HF patients, with good survival. However, it is still associated with some serious adverse events, of which neurological complications are the most critical. [ABSTRACT FROM AUTHOR]

Two women aged 26 and 41 were diagnosed with peripartum cardiomyopathy (PPCM). They presented with shortness of breath and oedematous ankles. The first woman presented in her 37th week of pregnancy. Her father had had dilated cardiomyopathy. A caesarean section was carried out. Her left ventricular function declined and she was therefore treated by means of an Impella heart pump and later, a left-ventricular assisting device. She eventually underwent urgent heart transplantation and recovered. The second woman presented 6 weeks after having given birth to twins. She was treated with a diuretic, an ACE inhibitor, a beta blocker and recovered. PPCM is a rare and potentially life-threatening form of dilated cardiomyopathy with left-ventricular systolic dysfunction that affects women in late pregnancy or in the early puerperium. Its pathogenesis is poorly understood. The generation of a cardiotoxic prolactin subfragment appears to play a key role in the pathophysiology. PPCM is difficult to diagnose as the initial complaints may be interpreted as the normal physiologic changes of pregnancy. In addition, prior definitions emphasising strict time windows, the lack of awareness and the rarity of the full-blown disease have sometimes resulted in the condition being overlooked and misdiagnosed.