1. Successful Bridge-to-Recovery Treatment in a Young Patient with Fulminant Eosinophilic Myocarditis: Roles of a Percutaneous Ventricular Assist Device and Endomyocardial Biopsy.
- Author
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Hasegawa-Tamba, Saki, Sugi, Keiki, Gatate, Yodo, Sugiyama, Kanako, Muramatsu, Toshihiro, Nishimura, Shigeyuki, Yasuda, Masanori, Fukushima, Kenji, and Nakano, Shintaro
- Subjects
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HEART assist devices , *THERAPEUTICS , *CARDIOGENIC shock , *CARDIAC magnetic resonance imaging , *MYOCARDITIS , *MYOCARDIAL perfusion imaging - Abstract
Eosinophilic myocarditis (EM) is a rare condition characterized by myocardial eosinophilic infiltration due to various underlying etiologies. The patient with EM may benefit from appropriate use of mechanical circulatory support (MCS) that acts as a bridge to myocardial recovery in response to effective immunosuppressive therapy. A 16-year-old boy presented with cardiogenic shock due to fulminant myocarditis, for which a percutaneous ventricular assist device (PVAD) was immediately inserted. Based on the histological diagnosis of EM, immunosuppressive therapy was immediately commenced, leading to improvement of left-ventricular ejection fraction (27% to 47%). The PVAD was successfully removed on day 7. Cardiac magnetic resonance imaging and dual-tracer myocardial scintigraphy suggested limited extent of irreversible myocardial damage. For fulminant EM, the short-term use of PVAD, together with immunosuppressive therapy guided by an immediate histological investigation, may be an effective bridging strategy to myocardial recovery. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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