Mechanical circulatory support for patients with acute-fulminant myocarditis

This report provides a review of mechanical circulatory support for patients in cardiogenic shock secondary to acute/fulminant myocarditis. Experience and outcomes with extracorporeal membrane oxygenation, left ventricular assist device support (ABIOMED, Thoratec, Thermo Cardiosystems, Novacor), and biventricular ventricular assist device support (ABIOMED, Thoratec) are described. Patients in cardiogenic shock secondary to acute myocarditis in its fulminant presentation can recover, surprisingly with normal cardiac function. An aggressive approach to the use of mechanical support is strongly justified. Survival, either by bridge to transplant or recovery, should approach 70%. Transplantation can often be avoided.