Myocardial recovery after mechanical support for acute myocarditis: Is sustained recovery predictable?

Background. At present, myocardial recovery with mechanical support for acu te myocarditis is a more frequently observed issue. However, predictive par ameters of a sustained myocardial recovery are still under investigation. Methods. Two recent cases of mechanical support for acute lymphocytic myoca rditis with two different outcomes are reported. Literature about this dise ase and predictability of a sustainable myocardial recovery are reviewed. Results. Acute lymphocytic myocarditis is an individual entity whose outcom e is associated with the importance of healed cell damage. Unfortunately, t here are no available means of quantifying the fibrotic scar and endomyocar dial biopsy has a high percentage of false-negative results. Echocardiograp hic assessment of systolic and diastolic cardiac function is difficult whil e under mechanical support and its significance is not obvious. Forthcoming development of Doppler could better correlate myocardial contractility and histology to be predictive of a sustained recovery after acute myocarditis under mechanical support. Conclusions. Long-lasting recovery after mechanical support for acute myoca rditis remains unpredictable in our experience. More predictive factors are needed. (C) 1999 by The Society of Thoracic Surgeons.