Ventricular assist device for a coronavirus disease 2019-affected heart

ESC Heart Fail. 2021 Feb;8(1):162-166. doi: 10.1002/ehf2.13120. Epub 2020 Nov 20.

Abstract

Coronavirus disease 2019 (COVID-19) is challenging the care for cardiovascular patients, resulting in serious consequences with increasing mortality in pre-diseased heart failure patients. In the current state of the pandemic, the physiopathology of COVID-19 affecting pre-diseased hearts and the management of terminal heart failure in COVID-19 patients remain unclear. We outline the findings of a young COVID-19 patient suffering from idiopathic cardiomyopathy who was treated for acute multi-organ failure and required cardiac surgery with implantation of a temporary right ventricular and durable left ventricular assist device (LVAD). For deeper translational insights, we used in-depth tissue analysis by electron and light sheet fluorescence microscopy revealing evidence for spatial distribution of severe acute respiratory syndrome coronavirus 2 in the heart. This indicates that in-depth analysis may represent a valuable tool in understanding indistinct clinical cases. We conclude that COVID-19 directly affects pre-diseased hearts, but the consequences can be treated successfully with LVAD implantation.

Keywords: COVID-19; Electron microscopy; Light sheet microscopy; SARS-CoV-2.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Biopsy
  • COVID-19 / complications*
  • COVID-19 / therapy
  • Cardiomyopathy, Dilated / etiology*
  • Cardiomyopathy, Dilated / pathology
  • Cardiomyopathy, Dilated / therapy
  • Heart-Assist Devices*
  • Humans
  • Male
  • Prosthesis Implantation
  • Ventricular Dysfunction, Left / etiology
  • Ventricular Dysfunction, Left / therapy