Successful bridge to recovery in fulminant myocarditis using a biventricular assist device: a case report View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2017-10-24

AUTHORS

Yusuke Adachi, Osamu Kinoshita, Masaru Hatano, Yukako Shintani, Noritsugu Naito, Mitsutoshi Kimura, Kan Nawata, Daisuke Nitta, Hisataka Maki, Kazutaka Ueda, Eisuke Amiya, Eiki Takimoto, Issei Komuro, Minoru Ono

ABSTRACT

BACKGROUND: Fulminant myocarditis is a life-threatening disease, and myocardial damage expands the right ventricle as well as the left ventricle in some cases. There is a mortality rate of over 40% in patients with fulminant myocarditis who need mechanical circulatory support by peripheral venoarterial extracorporeal membrane oxygenation. CASE PRESENTATION: We report a case of a 27-year-old Japanese woman who was successfully bridged to recovery by using a biventricular assist device. She was diagnosed with fulminant myocarditis, and peripheral venoarterial extracorporeal membrane oxygenation was established on the same day. Her left ventricular ejection fraction rapidly decreased from 40% to 5% in 3 days and weaning from venoarterial extracorporeal membrane oxygenation was deemed difficult. Therefore, we performed a ventricular assist device implantation on day 4. A left ventricular assist device was implanted first. However, adequate blood flow did not circulate to the left side of her heart because of right-sided heart failure. Thus, an additional implant of a right ventricular assist device was performed during the operation. Her left ventricular ejection fraction recovered to 50% on day 10. The biventricular assist device was successfully removed on day 14. She has not experienced worsening of biventricular function during her follow-ups for 4 years. CONCLUSIONS: Ventricular assist device therapy should be considered if there is no improvement in cardiac function in patients with fulminant myocarditis regardless of several days of support by venoarterial extracorporeal membrane oxygenation. A right ventricular assist device should always be implemented when necessary because biventricular involvement is not uncommon in fulminant myocarditis. More... »

PAGES

295

References to SciGraph publications

  • 2014-06-22. Current status of extracorporeal ventricular assist devices in Japan in JOURNAL OF ARTIFICIAL ORGANS
  • Identifiers

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    http://scigraph.springernature.com/pub.10.1186/s13256-017-1466-1

    DOI

    http://dx.doi.org/10.1186/s13256-017-1466-1

    DIMENSIONS

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    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/29061186


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