TandemHeart as a Bridge to Recovery in Legionella Myocarditis

Tex Heart Inst J. 2015 Aug 1;42(4):357-61. doi: 10.14503/THIJ-14-4131. eCollection 2015 Aug.

Abstract

Legionnaires' disease is the designation for pneumonia caused by the Legionella species. Among the rare extrapulmonary manifestations, cardiac involvement is most prevalent, in the forms of myocarditis, pericarditis, postcardiotomy syndrome, and prosthetic valve endocarditis. Mechanical circulatory support has proved to be a safe and effective bridge to myocardial recovery in patients with acute fulminant myocarditis; however, to our knowledge, this support has not been used in infectious myocarditis specifically related to Legionellosis. We describe a case of Legionella myocarditis associated with acute left ventricular dysfunction and repolarization abnormalities in a 48-year-old man. The patient fully recovered after left ventricular unloading with use of a TandemHeart percutaneous ventricular assist device. In addition, we review the English-language medical literature on Legionella myocarditis and focus on cardiac outcomes.

Keywords: Arrhythmias, cardiac/etiology; Legionnaires' disease/complications/diagnosis/drug therapy/prevention & control; heart-assist devices; immunoglobulins, intravenous/therapeutic use; myocarditis/complications/etiology; risk factors; treatment outcome; ventricular dysfunction, left/microbiology.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Electrocardiography
  • Heart-Assist Devices*
  • Humans
  • Legionella pneumophila / pathogenicity*
  • Legionnaires' Disease / complications
  • Legionnaires' Disease / diagnosis
  • Legionnaires' Disease / microbiology*
  • Male
  • Middle Aged
  • Myocarditis / diagnosis
  • Myocarditis / microbiology
  • Myocarditis / physiopathology
  • Myocarditis / therapy*
  • Prosthesis Design
  • Recovery of Function
  • Time Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Ventricular Dysfunction, Left / diagnosis
  • Ventricular Dysfunction, Left / microbiology
  • Ventricular Dysfunction, Left / physiopathology
  • Ventricular Dysfunction, Left / therapy*
  • Ventricular Function, Left*