CytoSorbents Corporation (CTSO)

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Biventricular failure and giant-cell myocarditis: A case report

This case was just published in The International Journal of Artificial Organs. This is a perfect summary of why myocarditis and bilirubin removal will be huge.

Giant cell myocarditis, the most lethal form of myocarditis, which is characterized by rapid deterioration, the prognosis is less favorable than in other forms of myocarditis. It is a very rare disease that is difficult to diagnose. The symptoms vary from simple fatigue to sudden death. Once a diagnosis is made it is easy to look back and connect these symptoms with giant cell myocarditis. But these same symptoms could have been due to a variety of non-life threatening conditions. Even if someone were taken to a hospital with minor unexplained symptoms a proper diagnosis would most likely not be made.

Hemoadsorption in cardiac shock with biventricular failure and giant-cell myocarditis: A case report
Günes Dogan, Jasmin Hanke, Jakob Puntigam, ...
First Published May 30, 2018 Research Article

Abstract
Purpose:
Giant-cell myocarditis represents a rare and often fatal autoimmune disorder. Despite extracorporeal life support being a valid treatment option, alternatives to control the underlying inflammatory response remain sparse. A new hemoadsorption device (CytoSorb) has recently been introduced to treat patients with an excessive inflammatory response.

Methods:
A 57-year-old patient developed fulminant right heart failure, respiratory insufficiency, hemodynamic instability, and oliguric–anuric renal failure. An extracorporeal life support together with an Impella was implanted for circulatory support. Due to non-pulsatility, acontractility of the left ventricle and a heavily reduced right ventricular function, a left ventricular assist device implantation and change from extracorporeal life support to veno-pulmonary arterial extracorporeal membrane oxygenation was performed. Since adequate hemodynamic stabilization could not be achieved and due to increasing inflammatory mediators and bilirubin levels, the decision was made to additionally integrate a CytoSorb hemoadsorber into the system.

Results:
The combined treatment resulted in a clear and steady improvement in hemodynamics and the inflammatory condition with marked reductions in all measured parameters throughout the treatment period. Metabolic acidosis resolved and liver function improved.

Conclusion:
Extracorporeal life support therapy represents a bridging approach to heart transplantation or to cardiac recovery and can be complemented by CytoSorb as an independent therapeutic option. The patient described herein with giant-cell myocarditis and fulminant cardiac failure who received substantial extracorporeal support in combination with CytoSorb hemoadsorption therapy benefited in terms of an improvement of organ function and his inflammatory situation.

http://journals.sagepub.com/doi/abs/10.1177/0391398818777362