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Acute Mechanical Circulatory Support for Fulminant Myocarditis Complicated by Cardiogenic Shock

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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.

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Authors and Affiliations

  1. Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, NY, 10032, USA

    Kanika P. Mody, Melana Yuzefpolskaya, Paolo C. Colombo, Ulrich P. Jorde & Nir Uriel

  2. Department of Surgery, Columbia University Medical Center, New York, NY, 10032, USA

    Hiroo Takayama, Elissa Landes & Yoshifumi Naka

  3. Columbia University Medical Center, New York, NY, 10032, USA

    Nir Uriel

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  1. Kanika P. Mody
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  2. Hiroo Takayama
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  4. Melana Yuzefpolskaya
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Correspondence to Nir Uriel.

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Associate Editor DeLisa Fairweather oversaw the review of this article

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Mody, K.P., Takayama, H., Landes, E. et al. Acute Mechanical Circulatory Support for Fulminant Myocarditis Complicated by Cardiogenic Shock. J. of Cardiovasc. Trans. Res. 7, 156–164 (2014). https://doi.org/10.1007/s12265-013-9521-9

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  • DOI: https://doi.org/10.1007/s12265-013-9521-9

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