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Use of Mechanical Circulatory Support in Isolated Right Heart Failure: A Bridge to Transplantation
Daniel J Beissel1, Brian F Birnbaum1, Aliessa P Barnes1
1Ward Family Heart Center, Children's Mercy Hospital, Kansas City, Missouri.
Insights
This study details a pediatric case of acute myocarditis presenting as right heart failure. An isolated right ventricular assist device was used as a bridge to cardiac transplantation, marking its first reported use.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Surgery
- Transplant Medicine
Background:
- Acute myocarditis can cause severe left ventricular dysfunction and necessitate cardiac transplantation.
- Right heart failure in infants can present with unclear etiology.
- Early diagnosis and intervention are crucial for managing pediatric heart failure.
Abstract:
Acute myocarditis may lead to left ventricular dysfunction and subsequent need for cardiac transplantation. We describe a 15-month-old child who presented with right heart failure of unclear cause. Echocardiography showed normal left ventricular function; however, right ventricular function was markedly reduced. The patient required extracorporeal membrane oxygenation followed by placement of a right-sided Berlin EXCOR ventricular assist device. There was little recovery, and the child underwent cardiac transplantation. Subsequent pathologic examination revealed lymphocytic myocarditis. We believe this is the first use of an isolated right ventricular assist device as a bridge to heart transplantation.
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