OBJECTIVE: Fulminant @entity2401 (FM) is an uncommon but life-threatening condition for which a @entity1457 ( @entity1457 ) device can be life-saving. However, device selection, weaning and explantation procedures remain poorly defined. METHODS: Four @entity1 were bridged to recovery using the Thoratec biventricular support device. All four were in a state of @entity1455 with rapid deterioration of their clinical status despite increasing doses of inotropes. Three @entity1 required mechanical respiratory support, three were anuric and one was dialyzed. Echocardiography showed a mean ejection fraction of 12+/-8%. RESULTS: Each Thoratec implantation was performed on cardiopulmonary bypass with a beating heart. Three @entity1 underwent biventricular cannulation. The fourth @entity1 underwent left ventricular and right atrial cannulation. All @entity1 manifested evidence of moderate to severe end organ dysfunction after device implantation. However, by explantation, end organ function had recovered in all @entity1 . After a mean duration of 17+/-10 days, all the @entity1 showed evidence of myocardial recovery. Recovery was confirmed on echocardiography which showed opening of the aortic valve and contraction of both ventricles. The weaning process was performed in 2-5 days by setting the device in a fixed mode and increasing the rate. Device explantation was uneventful in the four @entity1 . At the 6 months echocardiography follow-up, all had normal systolic function. CONCLUSION: In @entity1 with FM, biventricular support allows full circulatory support and unloads both ventricles until recovery occurs. In this set of @entity1 , weaning and removal procedures are straight-forward. These results suggest an aggressive stance toward implantation of @entity1457 in @entity1 with FM.

Circulatory support for fulminant XXXX : consideration for implantation, weaning and explantation.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity1457 :: ('MESH:D012769', 'Disease') :: ['mechanical circulatory support', 'MCS'] @entity1455 :: ('MESH:D012770', 'Disease') :: ['cardiogenic shock'] @entity2401 :: ('MESH:D009205', 'Disease') :: ['myocarditis']
@entity2401 :: (MESH:D009205,Disease) :: ['myocarditis']
