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Her condition quickly deteriorated to severe biventricular failure and cardiogenic shock requiring mechanical circulatory support. An endomyocardial biopsy revealed lymphocytic myocarditis with no PCR-detectable viral genomes, with CD8 T-cell predominance and pro-inflammatory macrophage expansion shown by myocardial flow cytometry. The therapy consisted of immunosuppression (high-dose methylprednisolone) and temporary mechanical circulatory support with enhanced ability to achieve left ventricular unloading by combination of extracorporeal membrane oxygenation with Impella (ECMELLA). After 2 weeks of support, complete and sustained recovery from myocarditis was observed.<\/jats:p>","DOI":"10.1002\/ehf2.12697","type":"journal-article","created":{"date-parts":[[2020,6,2]],"date-time":"2020-06-02T14:49:22Z","timestamp":1591109362000},"page":"1976-1981","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Complete Recovery of Fulminant Cytotoxic CD8 T-Cell-Mediated Myocarditis after ECMELLA Unloading and Immunosuppression"],"prefix":"10.1093","volume":"7","author":[{"given":"Ivana","family":"Jurcova","sequence":"first","affiliation":[{"name":"Department of Cardiology, Institute for Clinical and Experimental Medicine\u2014IKEM , Videnska 1958\/9, 140 21, Prague 4 ,","place":["Czech Republic"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan","family":"Rocek","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Institute for Clinical and Experimental 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