Successful bridge to recovery in fulminant myocarditis using a biventricular assist device: A case report

被引：7

作者：

Adachi Y. ^{[1
]}

Kinoshita O. ^{[2
]}

Hatano M. ^{[1
,3
]}

Shintani Y. ^{[4
]}

Naito N. ^{[2
]}

Kimura M. ^{[2
]}

Nawata K. ^{[2
]}

Nitta D. ^{[1
]}

Maki H. ^{[1
]}

Ueda K. ^{[1
,5
]}

Amiya E. ^{[1
]}

Takimoto E. ^{[1
,6
]}

Komuro I. ^{[1
]}

Ono M. ^{[2
]}

机构：

[1] Department of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo, Tokyo

[2] Department of Cardiac Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1, Hongo, Bunkyo-ku Tokyo

[3] Department of Therapeutic Strategy for Heart Failure, Graduate School of Medicine, University of Tokyo, Tokyo

[4] Department of Pathology, Graduate School of Medicine, University of Tokyo, Tokyo

[5] Department of Ubiquitous Preventive Medicine, Graduate School of Medicine, University of Tokyo, Tokyo

[6] Department of Advanced Translational Research and Medicine in Management of Pulmonary Hypertension, Graduate School of Medicine, University of Tokyo, Tokyo

来源：

Journal of Medical Case Reports | / 11卷 / 1期

基金：

日本学术振兴会;

关键词：

Biventricular assist device; Case report; Fulminant myocarditis; Peripheral venoarterial extracorporeal membrane oxygenation; Right heart failure; Ventricular assist device;

D O I：

10.1186/s13256-017-1466-1

中图分类号：

学科分类号：

摘要：

Background: 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. Case presentation: 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. Conclusions: 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. © 2017 The Author(s).

引用

共 11 条

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