Mechanical circulatory support for fulminant myocarditis.
OBJECTIVE
Fulminant myocarditis is potentially fatal because it progresses rapidly into cardiogenic shock; thus, immediate and appropriate treatment is essential. Mechanical circulatory support (MCS) is an important part of treatment for fulminant myocarditis. We review our experience of treating fulminant myocarditis with MCS.


METHODS
We used MCS with veno-arterial bypass (VAB) to treat seven patients with fulminant myocarditis. Five of these patients were younger than 18 years old. The mean time from arriving at our institution to the initiation of MCS was 15.9 +/- 22.6 h. MCS was initiated within 18 h in six patients.


RESULTS
The mean assist time of MCS was 70.9 +/- 35.0 h and six patients were weaned successfully (weaning rate: 85.7%). The remaining patient required support with VAB for 132 h, and a left ventricular assist device was applied. All seven patients were weaned off MCS and discharged.


CONCLUSIONS
Since severe and rapid hemodynamic compromise is typical of fulminant myocarditis, an immediate decision must be made about whether to initiate MCS. We attribute the excellent results and favorable long-term prognosis of our patients to the early initiation of MCS.
Sezai
Akira
A
Department of Cardiovascular Surgery, Nihon University School of Medicine, 30-1 Oyaguchi-kamimachi, Itabashi-ku, Tokyo, 173-8610, Japan.
Hata
Mitsumasa
M
Niino
Tetsuya
T
Yoda
Masataka
M
Takayama
Tadateru
T
Saito
Satoshi
S
Ayusawa
Mamoru
M
Minami
Kazutomo
K