title: Successful use of the Impella device in giant cell myocarditis as a bridge to permanent left ventricular mechanical support.
abstract: Idiopathic giant cell myocarditis is a rare condition with a poor prognosis. Patients with giant cell myocarditis typically die of refractory ventricular arrhythmias or progressive congestive heart failure in about 3 months. The benefit of immunosuppressive therapy varies among patients with giant cell myocarditis, and no factors that would predict which patients will respond to therapy have been identified. Mechanical circulatory support devices, from intra-aortic balloon pumps to more permanent systems, have been used for ventricular support in cases of acute heart failure.Herein, we describe a case of giant cell myocarditis in a previously healthy 44-year-old woman who presented with cardiogenic shock. She was supported hemodynamically with the Impella Recover LP 2.5 left ventricular assist device until a permanent device could be surgically implanted. To our knowledge, this is the 1st reported case of the successful use of the Impella device for hemodynamic support in a patient with giant cell myocarditis until more definitive treatment could be instituted.
authors.affiliation: Krannert Institute of Cardiology, Indiana University School of Medicine, Indianapolis, IN 46208, USA. hsuradi@iupui.edu
authors.forename: Hussam
authors.initials: H
authors.lastname: Suradi
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Breall
mesh_terms: D000328:Adult; D001706:Biopsy; D005260:Female; D015726:Giant Cells / Q000473:pathology*; D006353:Heart-Assist Devices; D006439:Hemodynamics; D006801:Humans; D009205:Myocarditis / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D011474:Prosthesis Design; D020127:Recovery of Function; D012770:Shock, Cardiogenic / Q000209:etiology / Q000628:therapy; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left