Usefulness of percutaneous left ventricular assist device as a bridge to recovery from myocarditis

The TandemHeart percutaneous left ventricular assist device is a left atrial-to-femoral artery bypass system that can be implanted percutaneously within 30 minutes and provides active circulatory support. The TandemHeart has been used mainly for temporary hemodynamic assistance during high-risk coronary interventions and postcardiotomy heart failure. This report describes initial experience with this device as a successful bridge to cardiac recovery in 3 patients with acute myocarditis. All patients presented with severe cardiogenic shock (mean cardiac index 1.1 L/min/m2), and end-organ perfusion could not be maintained despite intra-aortic balloon counterpulsation and the maximal use of vasopressive agents. The patients were successfully bridged to myocardial recovery with the TandemHeart (mean duration of support 5 days, range 2 to 8). The only complication was a short episode of ventricular fibrillation during device placement in 1 patient, which did not result in any morbidity or mortality. All patients were discharged home (mean duration of stay 15 days). In conclusion, the TandemHeart proved to be a safe and effective bridge to myocardial recovery in these patients with acute myocarditis.