Title |
Successful bridge to recovery in fulminant myocarditis using a biventricular assist device: a case report
|
---|---|
Published in |
Journal of Medical Case Reports, October 2017
|
DOI | 10.1186/s13256-017-1466-1 |
Pubmed ID | |
Authors |
Yusuke Adachi, Osamu Kinoshita, Masaru Hatano, Yukako Shintani, Noritsugu Naito, Mitsutoshi Kimura, Kan Nawata, Daisuke Nitta, Hisataka Maki, Kazutaka Ueda, Eisuke Amiya, Eiki Takimoto, Issei Komuro, Minoru Ono |
Abstract |
Fulminant myocarditis is a life-threatening disease, and myocardial damage expands the right ventricle as well as the left ventricle in some cases. There is a mortality rate of over 40% in patients with fulminant myocarditis who need mechanical circulatory support by peripheral venoarterial extracorporeal membrane oxygenation. We report a case of a 27-year-old Japanese woman who was successfully bridged to recovery by using a biventricular assist device. She was diagnosed with fulminant myocarditis, and peripheral venoarterial extracorporeal membrane oxygenation was established on the same day. Her left ventricular ejection fraction rapidly decreased from 40% to 5% in 3 days and weaning from venoarterial extracorporeal membrane oxygenation was deemed difficult. Therefore, we performed a ventricular assist device implantation on day 4. A left ventricular assist device was implanted first. However, adequate blood flow did not circulate to the left side of her heart because of right-sided heart failure. Thus, an additional implant of a right ventricular assist device was performed during the operation. Her left ventricular ejection fraction recovered to 50% on day 10. The biventricular assist device was successfully removed on day 14. She has not experienced worsening of biventricular function during her follow-ups for 4 years. Ventricular assist device therapy should be considered if there is no improvement in cardiac function in patients with fulminant myocarditis regardless of several days of support by venoarterial extracorporeal membrane oxygenation. A right ventricular assist device should always be implemented when necessary because biventricular involvement is not uncommon in fulminant myocarditis. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
United Kingdom | 1 | 50% |
Unknown | 1 | 50% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 1 | 50% |
Scientists | 1 | 50% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 23 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Other | 4 | 17% |
Researcher | 4 | 17% |
Student > Master | 3 | 13% |
Professor > Associate Professor | 2 | 9% |
Student > Ph. D. Student | 2 | 9% |
Other | 3 | 13% |
Unknown | 5 | 22% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 13 | 57% |
Pharmacology, Toxicology and Pharmaceutical Science | 1 | 4% |
Materials Science | 1 | 4% |
Nursing and Health Professions | 1 | 4% |
Unknown | 7 | 30% |