Acute mechanical circulatory support for fulminant myocarditis complicated by cardiogenic shock

Kanika P. Mody, Hiroo Takayama, Elissa Landes, Melana Yuzefpolskaya, Paolo C. Colombo, Yoshifumi Naka, Ulrich P. Jorde, Nir Uriel

Research output: Contribution to journalArticle

31 Scopus citations

Abstract

In fulminant myocarditis complicated by cardiogenic shock, early mechanical circulatory support (MCS) may prevent cardiomyopathy and death. We sought to examine the outcomes of patients with fulminant myocarditis supported with MCS. A retrospective review of patients with acute cardiogenic shock treated with MCS from 2007 to 2013 was conducted, and patients with a diagnosis of fulminant myocarditis were included in this series. At our center, 260 patients received MCS for acute cardiogenic shock, and 11 were implanted for fulminant myocarditis. Eight received the Centrimag biventricular assist device (BIVAD), and three received veno-arterial extracorporeal membrane oxygenator (VA ECMO), though 1 VA ECMO-supported patient was transitioned to BIVAD due to refractory shock. The mean acute support time was 14.7±4.4 days. Two patients required long-term left ventricular assist devices and were further supported for 55 and 112 days. Eight patients recovered with a mean ejection fraction of 54±7 %, and one was successfully transplanted. Eight patients survived to discharge (73 %) with mean follow-up: 292.6±306.8 days. All three deaths were due to neurologic complications. MCS should be considered in patients with fulminant myocarditis complicated by shock. With aggressive medical therapy, early utilization of MCS carries promising outcomes.

Original languageEnglish (US)
Pages (from-to)156-164
Number of pages9
JournalJournal of Cardiovascular Translational Research
Volume7
Issue number2
DOIs
StatePublished - Mar 2014
Externally publishedYes

Keywords

  • Acute mechanical circulatory support
  • Cardiogenic shock
  • Fulminant myocarditis

ASJC Scopus subject areas

  • Molecular Medicine
  • Genetics
  • Pharmaceutical Science
  • Cardiology and Cardiovascular Medicine
  • Genetics(clinical)

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