First successful bridge to recovery with the Impella Recover 100 left ventricular assist device for fulminant acute myocarditis.
A patient with septic and cardiogenic shock secondary to acute fulminant myocarditis was successfully treated by mechanical offloading of the left ventricle using the Impella Recover 100, a new implantable micro-axial blood pump designed for short-term circulatory support (for a maximum of 7 days). The possibility of implanting this device without using cardiopulmonary bypass allowed as to manage the septic shock, to reverse cardiac and hepatorenal failure and to wean the patient off treatment after 18 days of support. At 3 months the left and right ventricular function was satisfactory. The widespread application of this kind of support depends on the availability of an inexpensive "mini-invasive" blood pump, appropriate weaning protocols and emerging strategies to promote sustainable myocardial recovery.
Colombo
Tiziano
T
Cardiac Surgery Division, Department of Cardio-Thoracic Surgery, A. De Gasperis, Niguarda Ca, Granda Hospital, Milan, Italy. tcolombo@cesano.com
Garatti
Andrea
A
Bruschi
Giuseppe
G
Lanfranconi
Marco
M
Russo
Claudio
C
Milazzo
Filippo
F
Catena
Emanuele
E
Frigerio
Maria
M
Vitali
Ettore
E
D000208:Acute Disease; D000328:Adult; D003326:Coronary Circulation / Q000502:physiology; D004867:Equipment Design / Q000295:instrumentation; D006353:Heart-Assist Devices; D006801:Humans; D007423:Intra-Aortic Balloon Pumping; D008297:Male; D009205:Myocarditis / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D012770:Shock, Cardiogenic / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D012772:Shock, Septic / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D013318:Stroke Volume / Q000502:physiology; D016276:Ventricular Function / Q000502:physiology