Assessment of myocardial recovery in a patient with acute myocarditis supported with a left ventricular assist device: a case report.

Abstract

Acute myocarditis may present with profound hemodynamic compromise; however, spontaneous resolution of the inflammatory process may occur in up to half of such patients. In patients with fulminant myocarditis, mechanical circulatory support may serve as a bridge to myocardial recovery. In this report we describe a 35-year-old man with acute myocarditis who required left ventricular assist device support as a bridge to recovery, and suggest a method for determining the suitability and timing of device explantation. A combination of echocardiography, right heart catheterization, exercise testing and serial endomyocardial biopsies was used to determine the resolution of myocarditis, recovery of myocardial function and timing for device explantation. Successful device explantation was performed after 37 days of device support. Further study is required to assess the role of ventricular assist devices in combination with immunosuppressive therapy in the management of fulminant myocarditis.

• Authors: Simon Maybaum, Philip Stockwell, Yoshi Naka, Katherine Catanese, Margaret Flannery, Peter Fisher, Mehmet Oz, Donna Mancini
• Journal: The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation (J Heart Lung Transplant) Vol. 22 Issue 2 Pg. 202-9 (Feb 2003) ISSN: 1053-2498 [Print] United States
• PMID: 12581771 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Acute Disease
• Adult
• Biopsy
• Cardiac Catheterization
• Device Removal
• Echocardiography
• Exercise Test
• Heart-Assist Devices
• Humans
• Male
• Myocardial Contraction (physiology)
• Myocarditis (physiopathology, therapy)
• Myocardium (pathology)
• Time Factors