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Successful heart transplantation for COVID-19-associated post-infectious fulminant myocarditis

Baptiste Gaudriot1, Alexandre Mansour1,2, Vincent Thibault2,3

  • 1Department of Anesthesia and Critical Care, University Hospital of Rennes, Rennes, F-35000, France.

ESC Heart Failure
|May 2, 2021
PubMed

Insights

This case study details a young patient with severe COVID-19-associated myocarditis requiring extracorporeal membrane oxygenation and heart transplantation. Pathologic and serologic findings confirmed the post-infectious nature of the cardiac complication.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Transplantation

Background:

  • The 2019 coronavirus disease (COVID-19) presents with diverse clinical manifestations.
  • Post-infectious myocarditis, including acute and fulminant forms, is a recognized complication of COVID-19.

Observation:

  • A young patient presented with severe COVID-19-associated post-infectious fulminant myocarditis.
  • Despite maximal medical therapy, the patient's hemodynamic status deteriorated, necessitating veno-arterial extracorporeal membrane oxygenation (VA-ECMO).

Findings:

  • The patient required emergent heart transplantation on Day 11 due to persistent cardiac dysfunction.
  • Pathologic examination of the explanted heart and positive SARS-CoV-2 serology confirmed the diagnosis of post-infectious COVID-19-associated myocarditis.

Implications:

  • This case highlights the critical severity of COVID-19-associated fulminant myocarditis in young individuals.
  • It underscores the potential need for advanced mechanical circulatory support and heart transplantation in refractory cases.
  • Early recognition and diagnosis are crucial for managing this rare but life-threatening complication.

Keywords:
COVID-19Cardiogenic shockExtracorporeal membrane oxygenationFulminant myocarditisHeart transplantation

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