Fulminant myocarditis in adults and children: bi-ventricular assist device for recovery

Grinda, Jean-Michel; Chevalier, Patrick; D'Attellis, Nicola; Bricourt, Marie-Odile; Berrebi, Alain; Guibourt, Pierre; Fabiani, Jean-Noël; Deloche, Alain
December 2004
European Journal of Cardio-Thoracic Surgery;Dec2004, Vol. 26 Issue 6, p1169
Academic Journal
Abstract: Objective: Fulminant myocarditis (FM) is uncommon and may be followed by a rapidly intractable cardiogenic shock. We report five consecutive patients with FM successfully bridged to recovery with a mechanical paracorporel biventricular assist device (BiVAD). Methods: Five patients, four adults and one child (mean age 27+/-6 years, range, 5–36 years) underwent implantation from November 1999 to May 2003, for FM. Prior to implantation, all patients required maximal inotropic support, three of them had an intra-aortic balloon pump, the child had an extra-corporel membrane oxygenation (ECMO) support previously inserted in another institution. Cardiac catheterisation showed a mean CPW of 37+/-1mmHg, mean CVP 18+/-2mmHg, and mean CI 1.7+/-0.1l/min. Echocardiogram showed a severe biventricular hypokinesia, without any ventricular dilatation and a mean LVEF at 12.5%. Two patients were implanted in cardiac arrest under external cardiac resuscitation. All patients underwent BiVAD implantation (MEDOS HIA-VAD). A 72ml right paracorporel ventricle (a 23ml in the child) was instituted between the double stage venous canula used during CPB and a pulmonary artery outflow canula. A 80ml left paracorporel ventricle (a 25ml in the child) was instituted between a left ventricle apical canula and an aorta outflow canula. Results: There was no death. The mean duration support time was 11+/-6 days (from 7 to 21 days). Two patients experienced transitory deficiency due to a stroke. Four patients showed signs of FM on histological findings. Despite serologic examination and viral genome research on myocardial biopsies, pathogenic agents were not identified. At mean follow-up of 31+/-15 months, all the patients fully recovered with a mean LVEF=60% and no left ventricular dilatation. Conclusions: In FM with intractable cardiogenic shock, the use of a BiVAD as a bridge to recovery is a life saving approach and should be considered before multi-end organ failure.


Related Articles

  • The Source of Worsening Respiratory Symptoms. Spark, Ronald P. // Cortlandt Forum;10/25/2000, Vol. 13 Issue 10, p38 

    Describes the case of an ex-smoker patient who died of acute myocarditis. Diagnostic challenge; Symptoms and treatment; Autopsy's revelation of the cause of death.

  • Clozapine.  // Reactions Weekly;5/11/2013, Issue 1452, p13 

    The article presents a case study of 21-year-old patient diagnosed with eosinophilic constrictive perimyocarditis while administering clozapine.

  • Acute myocarditis associated with adenoviral infection in a patient with scleroderma. Dziadzio, Magdalena; Giovagnoni, Andrea; Pomponio, Giovanni; Recanatini, Andrea; della Costanza, Osmy Paci; Manzin, Aldo; Casagrande, Walter; Gabrielli, Armando // Clinical Rheumatology;Dec2003, Vol. 22 Issue 6, p487 

    We describe a 40-year-old man with limited scleroderma who presented with acute heart failure following a flu-like illness. He was known to have incomplete left anterior bundle branch block, initial isolated pulmonary hypertension with enlarged right atrium, and no pulmonary fibrosis. He...

  • Vivax malaria in an Amazonian child with dilated cardiomyopathy. Martins, Antonio C.; Lins, Jamille B.; Santos, Luana M. N.; Fernandes, Licia N.; Malafronte, Rosely S.; Maia, Teresa C.; Ribera, Melissa C. V.; Ribera, Ricardo B.; da Silva-Nunes, Monica // Malaria Journal;2014, Vol. 13 Issue 1, p2 

    A child living in the Brazilian Amazon region who had had vivax malaria at the age of 11 months was admitted three months later with a history of progressive dyspnoea and fever, which culminated in respiratory distress and severe dilated cardiomyopathy at hospital admission in a malaria-free...

  • Myocarditis.  // Diseases & Disorders: A Nursing Therapeutics Manual, 3rd edition;2007, p655 

    The article offers a nursing therapeutic guide to myocarditis. Myocarditis occurs myocardial cells are infiltrated by various forms of bacteria or viruses that damage the myocardium by inciting an inflammatory response. Its causes are discussed. Ways to assess myocarditis include determining the...

  • Which one is Worse? Acute Myocarditis and Co-existing Non-compaction Cardiomyopathy in the Same Patient. KARACA, OGUZ; CAKAL, BEYTULLAH; CAKAL, SINEM DENIZ; GULER, GAMZE BABUR; GULER, EKREM // Journal of Clinical & Diagnostic Research;Jun2015, Vol. 9 Issue 6, p1 

    An image of acute myocarditis and co-existing non-compaction cardiomyopathy in a patient is presented.

  • Isolated ventricular non-compaction in a patient initially diagnosed with arrhythmogenic right ventricular card iomyopathy. Wozniak, O.; Konka, M.; Wlodarska, E. K. // Heart;Mar2008, Vol. 94 Issue 3, p289 

    Two images of the heart of the patient with arrythmogenic right ventricular cardiomyopathy are presented.

  • Molecular and immunological aspects of dilated cardiomyophaty in pediatrics. Bogdan, Istrate; Steluta, Boroghină // Romanian Journal of Pediatrics;2011, Vol. 60 Issue 4, p344 

    This article tries briefly to describe some molecular and immunological particularities of dilated cardiomyopathy in children, without insisting too much on clinical aspects. The main purpose is to provide useful information on molecular diagnosis in this type of cardiomyopathy and to understand...

  • A Case and Review of Acute Lyme Cardiac Complications. HEGEROVA, LIVIA T.; OLSON, TIMOTHY C. // Minnesota Medicine;May2014, Vol. 97 Issue 5, p42 

    The article describes the case of a healthy 25-year-old woman presented to the emergency department with one day of fever, frontal headache and neck stiffness. Her clinical examination led to the diagnosis of a mild Lyme myocarditis. The patient responded to outpatient treatment of oral doxycycline.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics