Acute Fulminant Myocarditis Successfully Bridged to Recovery with Left Ventricular Assist Device and Complicated by Flail Mitral Valve

• Published in: Journal of Tehran University Heart Center Vol. 11; no. 1
• Main Authors: Pınar Türker Duyuler, Serkan Duyuler, Ekrem Şahan, Şeref Alp Küçüker
• Format: Journal Article
• Language: English
• Published: Tehran University of Medical Sciences 2016
• Subjects: Myocarditis • Heart-assist devices • Mitral valve
• ISSN: 1735-8620; 2008-2371

Acute fulminant myocarditis is a life-threatening inflammatory disease of the myocardium characterized by the rapid deterioration of the hemodynamic status of the affected individual. With prompt recognition and appropriate management, complete recovery of ventricular function is likely within a few weeks. We introduce a 28-year-old man with acute fulminant myocarditis, who experienced circulatory collapse following acute angina and dyspnea. The patient had high troponin levels with low ejection fraction and normal coronary arteries. He was successfully bridged to recovery with a left ventricular assist device but was complicated by flail mitral valve. Perioperative myocardial biopsy was also compatible with myocarditis.  At 4 months’ follow-up, the patient was stable with functional capacity I according to the New York Heart Association’s classification. A possible mechanism for this very rare complication is the rupture of the chordal structure secondary to the fragility of an inflamed subvalvular apparatus stretched by a recovered ventricle.