A Successful Case of Central ECMO with a Transapical Left Ventricular Vent for Fulminant Myocarditis
- VernacularTitle:心尖部ベント併用の central ECMO で救命した劇症型心筋炎の1例
- Author:
Kaori MORI
1
;
Motohiko GODA
1
;
Taisuke SHIBUYA
1
;
Norihisa TOMINAGA
1
;
Daisuke MACHIDA
1
;
Yukihisa ISOMATU
1
;
Shinichi SUZUKI
1
;
Munetaka MASUDA
1
Author Information
- Keywords: fulminant myocarditis; central ECMO; transapical left ventricular vent (TLVV); LV unloading
- From:Japanese Journal of Cardiovascular Surgery 2020;49(3):106-109
- CountryJapan
- Language:Japanese
- Abstract: We report a successful case of fulminant myocarditis treated with central ECMO with a transapical left ventricular vent (TLVV). A 33-year-old man was diagnosed with fulminant myocarditis with acute biventricular failure. Using a cardio-pulmonary bypass, we introduced central ECMO with ascending aortic perfusion, right atrial venous drainage and TLVV. After ancillary circulation, his cardiac function gradually improved. The endotracheal tube was removed 5 days after the surgery (POD 5), and he was weaned from ECMO on POD 7 and discharged on POD 38. Although there are many cases in which peripheral veno-arterial ECMO (VA-ECMO) is used for fulminant myocarditis, there is a drawback to VA-ECMO : left ventricle (LV) unloading may be incomplete. Insufficient LV unloading may cause pulmonary congestion or disadvantage in myocardial recovery. TLVV can be used as a solution to unload the left ventricle. Central ECMO with TLVV should be useful therapy for fulminant myocarditis.
