[Rare case of enterovirus myocarditis with consecutive acute heart failure and subsequent "rescue therapy" with biventricular assist device].
PATIENT HISTORY AND FINDINGS: A 37-year-old woman was admitted in cardiogenic shock and multiorgan failure. On echocardiography, left ventricular function was reduced, at that time, to 35%. The patient had been suffering from a cold for 1 week prior to admission. Within 24 h, left ventricular function dramatically decreased to 7%. Examinations included left-and right-heart catheter evaluation with removal of right ventricular biopsies. Histology and molecular pathology revealed the diagnosis of an enteroviral myocarditis.


METHODS
Imminently, a biventricular assist device (BVAD -Berlin Heart) was implanted.


METHODS
Postoperatively, only low-dose inotropic support was required. Under the requested anticoagulation, recurrent bleeding necessitated three rethoracotomies. Both renal and liver function normalized over time. On postoperative day 25, the BVAD was explanted without the need for cardiopulmonary bypass. Global ventricular function had normalized. The implantation of BVAD proved to be an efficient rescue therapy.
Augustin
Norbert
N
Deutsches Herzzentrum München, Klinik für Herz- und Gefässchirurgie an der Technischen Universität München, Munich.
Schreiber
Christian
C
Klingel
Karin
K
Kandolf
Reinhard
R
Lange
Rüdiger
R
D000328:Adult; D001706:Biopsy; D006328:Cardiac Catheterization; D004452:Echocardiography; D004769:Enterovirus Infections / Q000150:complications* / Q000175:diagnosis; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*; D006352:Heart Ventricles / Q000473:pathology; D006353:Heart-Assist Devices; D006801:Humans; D009102:Multiple Organ Failure / Q000209:etiology; D009205:Myocarditis / Q000150:complications* / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology; D012770:Shock, Cardiogenic / Q000209:etiology; D013997:Time Factors; D016277:Ventricular Function, Left