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http://dx.doi.org/10.5090/kjtcs.2010.43.1.20

The Usefulness of a Percutaneous Cardiopulmonary Support Device for the Treatment of Fulminant Myocarditis  

Lim, Juyoug (Department of Thoracic and Cardiovascular Sugery, Seoul Asan Hospital, University of Ulsan College of Medicine)
Jung, Sung Ho (Department of Thoracic and Cardiovascular Sugery, Seoul Asan Hospital, University of Ulsan College of Medicine)
Je, Hyoung-Gon (Department of Thoracic and Cardiovascular Surgery, Pusan National University Yangsan Hospital, Pusan National University College of Medicine)
Lee, Taek Yeon (Department of Thoracic and Cardiovascular Sugery, Seoul Asan Hospital, University of Ulsan College of Medicine)
Choo, Suk Jung (Department of Thoracic and Cardiovascular Sugery, Seoul Asan Hospital, University of Ulsan College of Medicine)
Lee, Jae Won (Department of Thoracic and Cardiovascular Sugery, Seoul Asan Hospital, University of Ulsan College of Medicine)
Chung, Cheol Hyun (Department of Thoracic and Cardiovascular Sugery, Seoul Asan Hospital, University of Ulsan College of Medicine)
Publication Information
Journal of Chest Surgery / v.43, no.1, 2010 , pp. 20-24 More about this Journal
Abstract
Background: Fulminant myocarditis is a rare, but life threatening condition. Its prognosis is related with proper management in the acute phase. A cardiopulmonary support device can be very useful in this phase. We report on our experiences with managing acute fulminant myocarditis with a cardiopulmonary support (CPS) device. Material and Method: We reviewed retrospectively 9 patients who had a CPS device used for their fulminant myocarditis between September, 2006 and October, 2008. A Capiox emergency bypass system (Terumo Inc, Tokyo, Japan) was percutaneously inserted in all the patients. Upon implantation, all the patients were in cardiogenic shock because of ventricular arrhythmia or severe left ventricular dysfunction. The mean left ventricular ejection fraction (EF) was $20{\pm}6%$ according to transthoracic echocardiography. Result: 3 patients died despite CPS. The CPS was bridged to a transplanted heart in one patient. The rest were successfully explanted after a mean time of $107{\pm}70$ hours of running. The mean EF after discharge was $56{\pm}7%$ without dilated cardiomyopathy. Conclusion: Fulminant myocarditis can be fatal, but its prognosis is excellent if these patients receive proper, timely treatment. A cardiopulmonary support device can be very useful in this acute period. However, the implantation and management protocol of cardiopulmonary support are not yet settled. Further study is necessary to lower the complications of cardiopulmonary support for patients with fulminant myocarditis.
Keywords
Myocarditis; Heart assist device; Heart transplantation; Cardiogenic shock;
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1 Kang SK, Park SS, Na MH, et al. Management of acute fulminant myocarditis using a left ventricular assist device; a case report. Korean J Thorac Cardiovasc Surg 2001;34:490-3
2 Maejima Y, Yasu T, Kubo N, et al. Long-term prognosis of fulminant myocarditis rescued by percutaneous cardiopulmonary support device. Circ J 2004;68:829-33   DOI   ScienceOn
3 Kawahito K, Murata S, Yasu T, et al. Usefulness of extracorporeal membrane oxygenation for treatment of fulminant myocarditis and circulatory collapse. Am J Cardiol 1998;82:910-1   DOI   PUBMED   ScienceOn
4 Kato S, Morimoto S, Hiramitsu S, Nomura M, Ito I, Hishida H. Use of percutaneous cardiopulmonary support with fulminant myocarditis and cardiogenic shock for improving prognosis. Am J Cardiol 1999;83:623-5   DOI   ScienceOn
5 Chen YS, Yu HY, Huang SC, et al. Experience and result of extracorporeal membrane oxygenation in treating fulminant myocarditis with shock: What mechanical support should be considered first? J Heart Lung Transplant 2005;24:81-7   DOI   ScienceOn
6 Aoyama N, Izumi T, Hiramori K, et al. National survey of fulminant myocarditis in Japan: Therapeutic guidelines and long-term prognosis of using percutaneous cardiopulmonary support for fulminant myocarditis: Special report from a scientific committee. Circ J 2002;66:133-44   DOI   ScienceOn
7 Rockman HA, Adamson RM, Dembitsky WP, Bonar JW, Jaski BE. Acute fulminant myocarditis: Long-term follow up after circulatory support with left ventricular assist device. Am Heart J 1991;121:922-6   DOI   ScienceOn
8 Lieberman EB, Hutchins GM, Herskowitz A, Rose NR, Baughman KL. Clinicopathologic description of myocarditis. J Am Coll Cardiol 1991;18:1617-26   DOI   PUBMED
9 Martin J, Sarai K, Schindler M, Van de Loo A, Yoshitake M, Beyersdorf F. MEDOS HIA-VAD biventricular assist device for bridge to recovery in fulminant myocarditis. Ann Thorac Surg 1997;63:1145-6   DOI   ScienceOn
10 Frexia X, Sionis A, Castel A, et al. Low troponin-I levels on admission are associated with worse prognosis in patients with fulminant myocarditis. Transplant Proc 2009;41:2234-6   DOI   ScienceOn
11 Leprince P, Combes A, Nicolas B, et al. Circulatory support for fulminant myocarditis consideration for implantation, weaning and explantation. Eur J Cardiothorac Surg 2003;24:399-403   DOI   ScienceOn
12 McCarthy RE, Boehmer JP, Hruban RH, et al. Long-term outcome of fulminant myocarditis as compared with acute(non-fulminant) myocarditis. N Engl J Med 2000;342:690-5   DOI   ScienceOn
13 Eriksson S, Halenius H, Pulkki H, et al. Negative interferences in cardiac troponin I immunoassays by circulating troponin auto-antibodies. Clin Chem 2005;51:839   DOI   ScienceOn
14 Chen YS, Ko WJ, Lin FY, et al. Preliminary result of an algorithm to select proper ventricular assist device for highrisk patients with extracorporeal membrane oxygenation support. J Heart Lung Transplant 2001;20:850-7   DOI   ScienceOn