Emergency biventricular assist device implantation for acute
cardiopulmonary failure in a patient with COVID-19
Abstract
Severe COVID-19 is a multisystem inflammatory disorder and knowledge and
experience with severe acute respiratory failure in infected patients
has grown considerably since reports of the first few cases. Little is
known about the effect of SARS-CoV-2 on the heart, and there has been a
suggestion from published literature that fulminant cardiac failure with
or without respiratory failure may occur several weeks following
infection. A young man presented after a recent viral illness. He was
found to be in severe cardiogenic shock and was implanted with an
emergency biventricular assist device, which also incorporated an
extracorporeal membrane oxygenator. He stabilised soon thereafter and
despite an intracerebral haemorrhage, which resolved, and bleeding into
the trachea following percutaneous tracheostomy, he survived to explant
and was successfully stepped down to a rehabilitation unit on
postoperative day 50. He tested positive for SARS-CoV-2 antibodies when
the test became available on postoperative day 33. We envisage there
will be many more such presentations of acute COVID-19-associated
cardiogenic shock and we recommend clinicians consider this diagnosis
when presented with an acutely unwell patient with an unclear diagnosis,
following a viral illness. These patients should be discussed as early
as possible with a transplant/mechanical circulatory support team.