[Left ventricular assist device in a five-year-old child: a bridge to recovery in a case of viral myocarditis].
BACKGROUND
Viral myocarditis can lead to heart failure that is refractory to medication. In these cases, a ventricular assist device is a good therapeutic option that can be used as a bridge to transplantation or recovery. We describe the first case in Portugal of recovery with ventricular assistance after severe myocarditis.


METHODS
A five-year-old boy with no previous cardiac disease presented with severe viral myocarditis, refractory to medical treatment, with positive serology for parvovirus B19 and Ebstein-Barr virus. A Berlin Heart Excor(®) was implanted 15 days after diagnosis. A biopsy at the time of implantation showed subendocardial fibrosis. After 40 days of assistance ventricular function recovered and the device was explanted. The patient was discharged from hospital 15 days later.


CONCLUSIONS
Survival of children with ventricular assistance has improved significantly because of earlier implantation and coagulation monitoring. The presence of subendocardial fibrosis in the context of myocarditis is not a mandatory indication for transplantation.
Serviços de Cardiologia Pediátrica, Hospital de Santa Cruz, Carnaxide, Portugal. margaridaoms@gmail.com
Margarida
M
Silva
Nuno
N
Carvalho
Graça
G
Nogueira
Patrícia
P
Costa
Rui
R
Rodrigues
Miguel
M
Abecasis
Manuela
M
Nunes
Rui
R
Anjos
José
J
Neves
D002675:Child, Preschool; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D009205:Myocarditis / Q000628:therapy* / Q000821:virology*