Table 2. Studies including more than ten adult patients with fulminant myocarditis treated with VA-ECMO and/or Impella®.
| Authors | Time | Patients, n | Age, yrs | Type of MCS | Biopsy performed | Time of support, day | Etiology | Complications | Outcomes |
| Data are presented as means ± SD. *Presented as median (interquartile range). **Presented as multicenter studies. ***Presented as regarding the complete fulminant myocarditis population. BiV: biventricular; eCPR: extracorporeal-cardiopulmonary resuscitation; EM: eosinophilic myocarditis; EMB: endomyocardial biopsy; GCM: giant cell myocarditis; HTx: heart transplant; IABP: intraao
rtic balloon pump; LM: lymphocytic myocarditis; LVAD: left ventricular assist device; MCS: mechanical circulatory support; NA: non-applicable; RRT: renal replacement therapy; VA-ECMO: venoarterial extracorporeal membrane oxygenation; VAP: ventilator-associated pneumonia. | |||||||||
| Aoyama N, et al.[114] | 1989–2000 | 52 | 48 ± 16 | Percutaneous cardiopulmonary support | NA (43 patients diagnosed on EMB) | NA | Idiopathic: 34
Viral: 14 Eosinophilic: 2 GCM: 2 |
NA | Survival and return to normal life: 57.7 % |
| Mirabel M, et al.[115] | 2002–2009 | 35 | NA | VA-ECMO | 61% (25 patients) | NA | LM: 20
GCM: 2 EM: 2 |
NA | Survival to discharge: 68.6% |
| Ishida K, et al.[116] | 1995–2010 | 20 | 45 ± 19 | VA-ECM | 60% | NA | NA | NA | Survival to discharge: 60% |
| Asaumi Y, et al.[117] | 1993–2001 | 14 | 38 ± 15 | VA-ECMO (43% IABP) | 64% | 5.4 (1.7–7.1)* | NA | NA | ECMO weaning and acute survival: 71% |
| Lorusso R, et al.[9] | 2008–2013 | 57 | 38 ± 12 | VA-ECMO (65% IABP)
eCPR: 21% |
26.3% | 9.9 ± 19 | Idiopathic: 80.6%
Viral: 17.5% Autoimmune: 1.7% |
Major complications in 70% | ECMO weaning: 75%
Survival to hospital discharge: 72% |
| Montero S, et al.[48] | 2002–2016 | 13 | 44 (21–76)* | VA-ECMO: 85%
LVAD: 8% BiV MEDOS: 8% eCPR: 15% |
38% | 10 (1–13)* | GCM: 100% | RRT: 61%
Hemorrhage: 61% VAP: 46% Bacteremia: 46% |
69% survival at 90-days & one year post-symptom onset
0% survival free from HTx at one year after symptom onset |
| Beurtheret S, et al.[118] | 2005–2009 | 14 | NA | VA-ECMO | NA | NA | NA | NA | Survival to discharge: 65% |
| Wu MY, et al.[103] | 2003–2010 | 16 | NA | VA-ECMO
eCPR: 31% |
NA | NA | Viral: 62%
Unknown: 32% Postpartum: 6% |
NA | Survival to discharge: 87.5% |
| Diddle JW, et al.[86]** | 1995–2014 | 147 | 31 (21–47)* | VA-ECMO: 91%
eCPR: 21% |
NA | 5.7 (2.9–8.6)* | Viral: 7%
Other: 93% |
NA | ECMO weaning: 69%
Survival to hospital discharge: 61% |
| Ammirati E, et al.[10] | 2001–2018 | 73
2 9 |
NA | VA-ECMO
Impella® Other |
100% | 8.5 (5–15)* | LM: 72.7%
GCM: 14.5% EM: 11.5% Sarcoidosis: 1.2%*** |
NA | Death on MCS: 13.9%
Recovery with MCS: 24.8% |
| Annamalai SK, et al.[119] | 2009–2016 | 34 | 42 ± 17 | Impella® (concomitant VA-ECMO in 6%) | 32% | 3.8 ± 3.1 | NA | Hemolysis: 12%
Anemia requiring transfusion: 18% RRT: 32% Limb ischemia: 9% Stroke: 6% Vascular complications: 12% |
Survival to hospital discharge: 62% |