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Impella装置在巨细胞性心肌炎中作为过渡到永久性左心室机械支持的桥梁的成功应用。

Successful use of the Impella device in giant cell myocarditis as a bridge to permanent left ventricular mechanical support.

作者信息

Suradi Hussam, Breall Jeffrey A

机构信息

Krannert Institute of Cardiology, Indiana University School of Medicine, Indianapolis, IN 46208, USA.

出版信息

Tex Heart Inst J. 2011;38(4):437-40.

Abstract

Idiopathic giant cell myocarditis is a rare condition with a poor prognosis. Patients with giant cell myocarditis typically die of refractory ventricular arrhythmias or progressive congestive heart failure in about 3 months. The benefit of immunosuppressive therapy varies among patients with giant cell myocarditis, and no factors that would predict which patients will respond to therapy have been identified. Mechanical circulatory support devices, from intra-aortic balloon pumps to more permanent systems, have been used for ventricular support in cases of acute heart failure.Herein, we describe a case of giant cell myocarditis in a previously healthy 44-year-old woman who presented with cardiogenic shock. She was supported hemodynamically with the Impella Recover LP 2.5 left ventricular assist device until a permanent device could be surgically implanted. To our knowledge, this is the 1st reported case of the successful use of the Impella device for hemodynamic support in a patient with giant cell myocarditis until more definitive treatment could be instituted.

摘要

特发性巨细胞性心肌炎是一种罕见疾病,预后较差。巨细胞性心肌炎患者通常在约3个月内死于难治性室性心律失常或进行性充血性心力衰竭。免疫抑制治疗对巨细胞性心肌炎患者的疗效因人而异,尚未发现可预测哪些患者会对治疗产生反应的因素。从主动脉内球囊泵到更永久性的系统,机械循环支持设备已被用于急性心力衰竭病例的心室支持。在此,我们描述一例44岁既往健康女性发生巨细胞性心肌炎并出现心源性休克的病例。在能够通过手术植入永久性设备之前,她接受了Impella Recover LP 2.5左心室辅助装置的血流动力学支持。据我们所知,这是首例报道的在巨细胞性心肌炎患者中成功使用Impella装置进行血流动力学支持直至能够采取更确定性治疗的病例。

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