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[Fulminant myocarditis successfully treated with a left ventricular assist device: a case report]
Katsuhito Ueno1, Toshio Konishi, Mutsumu Fukata
1Division of Cardiovascular Surgery, Yokohama Rosai Hospital, Kozukue-machi 3211, Kohoku-ku, Yokohama 222-0036.
Journal of Cardiology
|June 11, 2003
Summary
Acute fulminant myocarditis can be effectively treated with a left ventricular assist device (LVAD) for circulatory support. This case highlights LVAD as a viable option for patients with severe myocarditis and ventricular arrhythmias.
Area of Science:
- Cardiology
- Critical Care Medicine
- Virology
Background:
- Acute myocarditis can lead to severe hemodynamic compromise and life-threatening ventricular arrhythmias.
- Fulminant myocarditis presents a significant challenge in critical care settings, often requiring advanced circulatory support.
Observation:
- A young woman with acute viral myocarditis developed uncontrollable ventricular arrhythmia requiring intraaortic balloon pumping and percutaneous cardiopulmonary support.
- Despite improved hemodynamics, decreased platelet count was observed, necessitating further intervention.
Findings:
- A left ventricular assist device (LVAD) was successfully implanted, allowing weaning from percutaneous cardiopulmonary support.
- The patient was weaned from the LVAD on postoperative day five, with full recovery of myocardial function confirmed by biopsy.
- Myocardial biopsy confirmed acute viral myocarditis as the underlying cause.
Implications:
- This case suggests that LVAD can provide effective and potentially life-saving circulatory support in acute fulminant myocarditis.
- LVAD implantation may be a crucial therapeutic option for patients experiencing severe cardiac dysfunction due to viral myocarditis.
- Further research into the role of mechanical circulatory support in fulminant myocarditis is warranted.