Assessment of myocardial recovery in a patient with acute myocarditis supported with a left ventricular assist device: a case report.
Acute myocarditis may present with profound hemodynamic compromise; however, spontaneous resolution of the inflammatory process may occur in up to half of such patients. In patients with fulminant myocarditis, mechanical circulatory support may serve as a bridge to myocardial recovery. In this report we describe a 35-year-old man with acute myocarditis who required left ventricular assist device support as a bridge to recovery, and suggest a method for determining the suitability and timing of device explantation. A combination of echocardiography, right heart catheterization, exercise testing and serial endomyocardial biopsies was used to determine the resolution of myocarditis, recovery of myocardial function and timing for device explantation. Successful device explantation was performed after 37 days of device support. Further study is required to assess the role of ventricular assist devices in combination with immunosuppressive therapy in the management of fulminant myocarditis.
Maybaum
Simon
S
Circulatory Physiology, Columbia University, New York, New York, USA. swm17@columbia.edu
Stockwell
Philip
P
Naka
Yoshi
Y
Catanese
Katherine
K
Flannery
Margaret
M
Fisher
Peter
P
Oz
Mehmet
M
Mancini
Donna
D
D000208:Acute Disease; D000328:Adult; D001706:Biopsy; D006328:Cardiac Catheterization; D020878:Device Removal; D004452:Echocardiography; D005080:Exercise Test; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D009200:Myocardial Contraction / Q000502:physiology; D009205:Myocarditis / Q000503:physiopathology / Q000628:therapy*; D009206:Myocardium / Q000473:pathology; D013997:Time Factors