Abstract
A previously healthy 37-year-old woman was diagnosed with acute myocarditis and admitted to the local hospital. Despite maximal inotropic support she became hypotensive, requiring introduction of intra-aortic balloon pumping (IABP). Subsequently, she was transferred to our hospital for further treatment, where she was diagnosed with cardiogenic shock and multiple organ failure. She required intubation, following which percutaneous cardiopulmonary support (PCPS) and continuous hemodiafiltration were introduced. Four days of support with PCPS did not affect cardiac recovery, and we implanted a left ventricular assist device (LVAD) on day 5 after admission. A right ventricular assist device (RVAD) was added because her right ventricular function had deteriorated. Her cardiac function gradually recovered, and she was successfully weaned from both LVAD and RVAD on postoperative day (POD) 11. We could remove IABP on POD 14. She was weaned from the respirator on POD 24, discharged from ICU on POD 29, and was weaned from hemodialysis on POD 49. After rehabilitation, the patient was discharged from our hospital on POD 102. VAD may provide strong mechanical circulatory support for patients with fulminant myocarditis, which is resistant to conventional therapy including IABP or PCPS. Early induction of VAD is recommended before organ failure advances.