Transseptal decompression of the left heart during ECMO for severe myocarditis.
A 16-month-old boy suffered a cardiac arrest as a result of acute myocarditis, and venoarterial extracorporeal membrane oxygenation was instituted. Twelve hours later, acute left heart distention developed with cessation of left ventricular ejection. Under transesophageal echocardiographic guidance, a long introducer was placed into the left atrium through a transseptal puncture and connected in-line to the venous circuit. Within hours, left ventricular function improved and ejection returned. Left heart decompression was continued for 5 days, and the patient was weaned from extracorporeal membrane oxygenation after 6 days with normal cardiac and neurologic function.
Ward
K E
KE
Department of Pediatrics, Childrens Hospital of Oklahoma, University of Oklahoma Health Sciences Center, Oklahoma City.
Tuggle
D W
DW
Gessouroun
M R
MR
Overholt
E D
ED
Mantor
P C
PC
D006328:Cardiac Catheterization; D006332:Cardiomegaly / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D017548:Echocardiography, Transesophageal; D015199:Extracorporeal Membrane Oxygenation; D006323:Heart Arrest / Q000209:etiology / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D006325:Heart Atria / Q000473:pathology*; D006346:Heart Septum; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D007223:Infant; D008297:Male; D009205:Myocarditis / Q000150:complications / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D011677:Punctures; D012720:Severity of Illness Index; D016277:Ventricular Function, Left