Novel Combination of Impella and Extra Corporeal Membrane Oxygenation as a Bridge to Full Recovery in Fulminant Myocarditis
A 31-year-old male was transferred to our hospital with severe heart failure due to viral myocarditis. He progressed to multiorgan failure requiring intubation and maximal doses of multiple vasopressors. Circulatory support was provided with an Impella device as a bridge to an extracorporeal membran...
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| Format: | Article |
| Language: | English |
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Wiley
2012-01-01
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| Series: | Case Reports in Critical Care |
| Online Access: | http://dx.doi.org/10.1155/2012/459296 |
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| author | Sachin Narain Gian Paparcuri Thomas M. Fuhrman Richard B. Silverman William T. Peruzzi |
| author_facet | Sachin Narain Gian Paparcuri Thomas M. Fuhrman Richard B. Silverman William T. Peruzzi |
| author_sort | Sachin Narain |
| collection | DOAJ |
| description | A 31-year-old male was transferred to our hospital with severe heart failure due to viral myocarditis. He progressed to multiorgan failure requiring intubation and maximal doses of multiple vasopressors. Circulatory support was provided with an Impella device as a bridge to an extracorporeal membrane oxygenation (ECMO) system. On full mechanical cardiovascular support, the patient's hemodynamic status improved and ECMO and Impella were explanted after 48 hours. Three days later, he was extubated and continued on to a full recovery. There are no specific therapies for fulminant myocarditis but first-line treatment is supportive care. ECMO is commonly used in patients with severe heart failure. In severe systolic dysfunction, left ventricular decompression is required to reduce myocardial wall stress, decrease myocardial oxygen requirements, and enhance the chances of recovery. The Impella, an active support system, is less invasive than classical decompressive techniques and is associated with lower requirements for blood products with fewer thromboembolic complications. This is the only case reported of the contemporary use of Impella and ECMO as a bridge to full recovery in an adult with myocarditis. It also presents a novel use of the Impella device in decompressing the left ventricle of an adult patient on ECMO. |
| format | Article |
| id | doaj-art-7d6a909d6fcb4d439fb0b30b239e59c7 |
| institution | OA Journals |
| issn | 2090-6420 2090-6439 |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Critical Care |
| spelling | doaj-art-7d6a909d6fcb4d439fb0b30b239e59c72025-08-20T02:07:12ZengWileyCase Reports in Critical Care2090-64202090-64392012-01-01201210.1155/2012/459296459296Novel Combination of Impella and Extra Corporeal Membrane Oxygenation as a Bridge to Full Recovery in Fulminant MyocarditisSachin Narain0Gian Paparcuri1Thomas M. Fuhrman2Richard B. Silverman3William T. Peruzzi4Department of Anesthesiology, Perioperative Medicine and Pain Management, University of Miami Miller School of Medicine, 1611 NW 12th Avenue (C-301), Miami, FL 33136, USADepartment of Anesthesiology, Perioperative Medicine and Pain Management, University of Miami Miller School of Medicine, 1611 NW 12th Avenue (C-301), Miami, FL 33136, USADepartment of Anesthesiology, Perioperative Medicine and Pain Management, University of Miami Miller School of Medicine, 1611 NW 12th Avenue (C-301), Miami, FL 33136, USADepartment of Anesthesiology, Perioperative Medicine and Pain Management, University of Miami Miller School of Medicine, 1611 NW 12th Avenue (C-301), Miami, FL 33136, USADepartment of Anesthesiology, Perioperative Medicine and Pain Management, University of Miami Miller School of Medicine, 1611 NW 12th Avenue (C-301), Miami, FL 33136, USAA 31-year-old male was transferred to our hospital with severe heart failure due to viral myocarditis. He progressed to multiorgan failure requiring intubation and maximal doses of multiple vasopressors. Circulatory support was provided with an Impella device as a bridge to an extracorporeal membrane oxygenation (ECMO) system. On full mechanical cardiovascular support, the patient's hemodynamic status improved and ECMO and Impella were explanted after 48 hours. Three days later, he was extubated and continued on to a full recovery. There are no specific therapies for fulminant myocarditis but first-line treatment is supportive care. ECMO is commonly used in patients with severe heart failure. In severe systolic dysfunction, left ventricular decompression is required to reduce myocardial wall stress, decrease myocardial oxygen requirements, and enhance the chances of recovery. The Impella, an active support system, is less invasive than classical decompressive techniques and is associated with lower requirements for blood products with fewer thromboembolic complications. This is the only case reported of the contemporary use of Impella and ECMO as a bridge to full recovery in an adult with myocarditis. It also presents a novel use of the Impella device in decompressing the left ventricle of an adult patient on ECMO.http://dx.doi.org/10.1155/2012/459296 |
| spellingShingle | Sachin Narain Gian Paparcuri Thomas M. Fuhrman Richard B. Silverman William T. Peruzzi Novel Combination of Impella and Extra Corporeal Membrane Oxygenation as a Bridge to Full Recovery in Fulminant Myocarditis Case Reports in Critical Care |
| title | Novel Combination of Impella and Extra Corporeal Membrane Oxygenation as a Bridge to Full Recovery in Fulminant Myocarditis |
| title_full | Novel Combination of Impella and Extra Corporeal Membrane Oxygenation as a Bridge to Full Recovery in Fulminant Myocarditis |
| title_fullStr | Novel Combination of Impella and Extra Corporeal Membrane Oxygenation as a Bridge to Full Recovery in Fulminant Myocarditis |
| title_full_unstemmed | Novel Combination of Impella and Extra Corporeal Membrane Oxygenation as a Bridge to Full Recovery in Fulminant Myocarditis |
| title_short | Novel Combination of Impella and Extra Corporeal Membrane Oxygenation as a Bridge to Full Recovery in Fulminant Myocarditis |
| title_sort | novel combination of impella and extra corporeal membrane oxygenation as a bridge to full recovery in fulminant myocarditis |
| url | http://dx.doi.org/10.1155/2012/459296 |
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