Key result
Switching to Impella 5.0 support rapidly increased cardiac power output to 0.8 watts and facilitated prompt recovery from profound cardiogenic shock in a patient with fulminant viral myocarditis.
Case Report (n=1)
No
Impella 5.0 support provided sufficient systemic perfusion and left ventricular unloading, facilitating prompt recovery in a patient with recurrent fulminant viral myocarditis and profound cardiogenic shock.
May support Impella 5.0 in select fulminant myocarditis shock; hypothesis-generating and requires prospective trials before wider use.
We herein report the clinical potential of Impella 5.0 support, which is a catheter-mounted micro-axial left ventricular support device, in a 39-year-old man with recurrent fulminant viral myocarditis complicated with profound cardiogenic shock despite inotropic infusion and an intra-aortic balloon pumping. Switching from these therapies to the Impella 5.0 device provided sufficient systemic perfusion with well-controlled left ventricular diastolic properties to facilitate a prompt recovery from profound cardiogenic shock. The patient was uneventfully discharged on the 27th hospital day. Given its effect of cardiac protection with sufficient systemic perfusion, the Impella device should be considered the first-line therapy for the treatment of fulminant myocarditis complicated with cardiogenic shock.
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Ogawa et al. (2019) conducted a case report in Recurrent fulminant viral myocarditis with profound cardiogenic shock (n=1). Impella 5.0 vs. Intra-aortic balloon pumping and inotropic infusion was evaluated on Hemodynamic recovery (cardiac power output). Switching to Impella 5.0 support rapidly increased cardiac power output to 0.8 watts and facilitated prompt recovery from profound cardiogenic shock in a patient with fulminant viral myocarditis.
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