Report on Treatment and Outcomes of Fulminant Myocarditis Patients Treated with Cardiopulmonary Support Devices in Our Hospital

BackgroundFulminant myocarditis is one of the most fatal diseases which has poor prognosis. Because of critical hemodynamic condition, cardiopulmonary support devices such as percutaneous cardiopulmonary support (PCPS) and ventricular assist device (VAD) was often needed. Although treatments and devices were innovated, recent reports on prognosis of fulminant myocarditis were limited.PurposeTo clarify outcomes of fulminant myocarditis treated with cardiopulmonary support devices.Methods and Results10 adult patients of fulminant myocarditis who were treated with cardiopulmonary support devices in our hospital from November 2008 to May 2015 were retrospectively reviewed. All patients were treated with PCPS, and four of them switched to paracorporeal VAD. Among these patients, one patient died in perioperative period by sepsis and two patients died in chronic period by thromboembolic events. One patient was recovered and explanted VAD. One patients died by thromboembolic cerebral hemorrhage before using VAD. Other 5 patients who were treated with only PCPS were alive and could be weaned from PCPS (mean PCPS duration: 6.8 days). We determined indication of VAD using impairment of aortic valve opening as a reference in recent three patients, and all of these patients were recovered without neurological complications.ConclusionAppropriate adoption of VAD may improve the outcomes of fulminant myocarditis and impairment of aortic valve opening may be a useful indicator of VAD implantation. BackgroundFulminant myocarditis is one of the most fatal diseases which has poor prognosis. Because of critical hemodynamic condition, cardiopulmonary support devices such as percutaneous cardiopulmonary support (PCPS) and ventricular assist device (VAD) was often needed. Although treatments and devices were innovated, recent reports on prognosis of fulminant myocarditis were limited. Fulminant myocarditis is one of the most fatal diseases which has poor prognosis. Because of critical hemodynamic condition, cardiopulmonary support devices such as percutaneous cardiopulmonary support (PCPS) and ventricular assist device (VAD) was often needed. Although treatments and devices were innovated, recent reports on prognosis of fulminant myocarditis were limited. PurposeTo clarify outcomes of fulminant myocarditis treated with cardiopulmonary support devices. To clarify outcomes of fulminant myocarditis treated with cardiopulmonary support devices. Methods and Results10 adult patients of fulminant myocarditis who were treated with cardiopulmonary support devices in our hospital from November 2008 to May 2015 were retrospectively reviewed. All patients were treated with PCPS, and four of them switched to paracorporeal VAD. Among these patients, one patient died in perioperative period by sepsis and two patients died in chronic period by thromboembolic events. One patient was recovered and explanted VAD. One patients died by thromboembolic cerebral hemorrhage before using VAD. Other 5 patients who were treated with only PCPS were alive and could be weaned from PCPS (mean PCPS duration: 6.8 days). We determined indication of VAD using impairment of aortic valve opening as a reference in recent three patients, and all of these patients were recovered without neurological complications. 10 adult patients of fulminant myocarditis who were treated with cardiopulmonary support devices in our hospital from November 2008 to May 2015 were retrospectively reviewed. All patients were treated with PCPS, and four of them switched to paracorporeal VAD. Among these patients, one patient died in perioperative period by sepsis and two patients died in chronic period by thromboembolic events. One patient was recovered and explanted VAD. One patients died by thromboembolic cerebral hemorrhage before using VAD. Other 5 patients who were treated with only PCPS were alive and could be weaned from PCPS (mean PCPS duration: 6.8 days). We determined indication of VAD using impairment of aortic valve opening as a reference in recent three patients, and all of these patients were recovered without neurological complications. ConclusionAppropriate adoption of VAD may improve the outcomes of fulminant myocarditis and impairment of aortic valve opening may be a useful indicator of VAD implantation. Appropriate adoption of VAD may improve the outcomes of fulminant myocarditis and impairment of aortic valve opening may be a useful indicator of VAD implantation.