MECHANICAL CIRCULATORY SUPPORT AND HEART TRANSPLANTATION AS A TREATMENT Of ACUTE MYOCARDITIS

Purpose. To evaluate the outcomes of the treatment of acute myocarditis by mechanical circulatory support and heart transplantation (HT).

Materials and Methods. We studied the medical records of 5 patients (3 women, men – 2). They suffered acute myocarditis complicated with cardiogenic shock, which required extracorporeal membrane oxygenation (ECMO) and / or the HT. The age of patients ranged from 22 to 59 years.

Results. In four patients ECMO was used, considering the growing multi-organ failure. At the same time in two patients ECMO served as a «bridge to the HT», in 1 patient there was a complete recovery of left ventricular systolic function, one woman died on the fifth day of hospital stay. One patient made the HT without prior treatment of mechanical circulatory support. The residence time in the hospital before the HT ranged from 10 to 96 days. 2 recipients died during the observation in the postoperative period: one for 1 month after surgery (purulent complications), one recipient on the 8th month after the HT ( rejection of heart transplant to the damage of immunosuppressive therapy). The duration of follow-up was 5 days to 3.5 years (depending on the outcome of the disease).

Conclusion. According to the domestic and foreign literature, based on our own experience, we can say that the mechanical circulatory support, including ECMO, and / or heart transplantation may increase the chances of a favorable outcome the acute myocarditis.

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