Bridge-to-recovery from acute myocarditis in a 12-year-old child.
Fulminant myocarditis causes substantial morbidity and mortality, especially in children and young adults. Mechanical circulatory support has become the standard therapy to bridge patients with intractable heart failure to either transplantation or myocardial recovery. Yet, successful weaning from biventricular support with full recovery is extremely rare in the pediatric population. This report describes the successful use of the MEDOS HIA ventricular assist device to bridge a 12-year-old girl to myocardial recovery in a biventricular bypass configuration. The left and right ventricle were completely off-loaded by the pumps and the device provided sufficient cardiac output to normalize end-organ function. Anticoagulation was maintained with i.v. heparin infusion. No neurological complications were detectable and the pump system was free of any macroscopic thrombi. After 19 days of support, cardiac function had recovered and the patient was successfully weaned from the device. Following physical rehabilitation, the patient was discharged home.
Hotz
Holger
H
Klinik für kardiovaskuläre Chirurgie, Universitätsklinikum Charité der Humboldt-Universität zu Berlin, Schumannstrasse 21, 10119 Berlin, Germany.
Linneweber
Joerg
J
Dohmen
Pascal M
PM
Vargas
Ortrud
O
Braun
Jan
J
Konertz
Wolfgang
W
D000208:Acute Disease; D002648:Child; D017548:Echocardiography, Transesophageal; D005260:Female; D005500:Follow-Up Studies; D006334:Heart Function Tests; D006353:Heart-Assist Devices; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D009205:Myocarditis / Q000000981:diagnostic imaging / Q000601:surgery*; D020127:Recovery of Function; D018570:Risk Assessment; D012720:Severity of Illness Index; D012770:Shock, Cardiogenic / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000502:physiology