Hostname: page-component-586b7cd67f-vdxz6 Total loading time: 0 Render date: 2024-11-23T00:38:14.188Z Has data issue: false hasContentIssue false
  • English
  • Français

Fulminant cytomegalovirus myocarditis in an infant with concomitant large atrial and ventricular septal defects: medical intervention strategy for functional cardiac regeneration

Published online by Cambridge University Press:  21 December 2018

Roland Schrewe Open the ORCID record for Roland Schrewe [Opens in a new window] ,
Anoosh Esmaeili ,
Kachina Behnke-Hall  and
Dietmar Schranz
Roland Schrewe*
Affiliation:
Pediatric Cardiology, Goethe University, Frankfurt/Main, Germany
Anoosh Esmaeili
Affiliation:
Pediatric Cardiology, Goethe University, Frankfurt/Main, Germany
Kachina Behnke-Hall
Affiliation:
Pediatric Cardiology, Goethe University, Frankfurt/Main, Germany
Dietmar Schranz
Affiliation:
Pediatric Cardiology, Goethe University, Frankfurt/Main, Germany
*
Author for correspondence: Dr. R. Schrewe (Medicine), Universitätsklinikum Frankfurt, Zentrum der Kinderheilkunde und Jugendmedizin, Pädiatrische Kardiologie und Angeborene Herzfehler, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany. Tel: +49-069-63016022; Fax: +49-069-63016437; E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

A cytomegalovirus-associated heart failure in a young infant with atrial and ventricular septal defects is reported in this case report. The patient recovered by an anti-congestive and anti-viral therapy with an extra percutaneous transcatheter treatment strategy. In the context of bi-ventricular predominant right heart failure associated with supra-systemic pulmonary hypertension, the already closed arterial duct was re-opened and stented to unload the right ventricle and thereby augment the systemic blood flow. Either the left-to-right shunting atrial septal defect or bi-directional shunting ventricular septal defect was involved in the disease process and was not able to avoid global heart failure. After clinical improvement, the stented duct was shunted left-to-right and was occluded with an ADO-II-AS. During the same procedure the atrial septal defect was closed with an Amplatzer-ASD occluder, while the peri-membranous ventricular septal defect was closed with an ADO-II occluder 2 months later.

Keywords

Cytomegalovirusheart failurepulmonary hypertensionre-ductingtranscatheter cardiac shunt closure
Type
Original Article
Information
Cardiology in the Young , Volume 29 , Issue 3 , March 2019 , pp. 277 - 279
Copyright
© Cambridge University Press 2018. 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Cite this article: Schrewe R, Esmaeili A, Behnke-Hall K, Schranz D. (2019) Fulminant cytomegalovirus myocarditis in an infant with concomitant large atrial and ventricular septal defects: medical intervention strategy for functional cardiac regeneration. Cardiology in the Young29: 277–279. doi: 10.1017/S1047951118002160

References

1. Drucker, NA, Colan, SD, Lewis, AB, et al. Gamma-globulin treatment of acute myocarditis in the pediatric population. Circulation 1994; 89: 252–257.10.1161/01.CIR.89.1.252Google Scholar
2. Kanda, T, Adachi, H, Ohno, T, et al. Myocardial beta-receptor and cardiac angiotensin alterations during the acute and chronic phases of viral myocarditis. Eur Heart J 1994; 15: 686–690.10.1093/oxfordjournals.eurheartj.a060568Google Scholar
3. Popovic, Z, Miric, M, Vasiljevic, J, et al. Acute hemodynamic effects of metoprolol ± nitroglycerin in patients with biopsy-proven lymphocytic myocarditis. Am J Cardiol 1998; 81: 801–804.10.1016/S0002-9149(97)01034-5Google Scholar
4. Kindermann, I, Kindermann, M, Kandolf, R, et al. Predictors of outcome in patients with suspected myocarditis. Circulation 2008; 118: 639–648.10.1161/CIRCULATIONAHA.108.769489Google Scholar
5. Schranz, D, Voelkel, NF. “Nihilism” of chronic heart failure therapy in children and why effective therapy is withheld. Eur J Pediatr 2016; 175: 445–455.10.1007/s00431-016-2700-3Google Scholar
6. Latus, H, Apitz, C, Moysich, A, Kerst, G, Jux, C, Bauer, J, Schranz, D. Creation of a functional Potts shunt by stenting the persistent arterial duct in newborns and infants with suprasystemic pulmonary hypertension of various etiologies. J Heart Lung Transplant 2014; 33: 542–546.10.1016/j.healun.2014.01.860Google Scholar
7. Schranz, D, Akintuerk, H, Voelkel, NF. End-stage’ heart failure therapy: potential lessons from congenital heart disease: from pulmonary artery banding and interatrial communication to parallel circulation. Heart 2017; 103: 262–267.10.1136/heartjnl-2015-309110Google Scholar