Biventricular assist device for scombroid poisoning with refractory myocardial dysfunction: a bridge to recovery.
We report the usefulness of biventricular mechanical circulatory support in a 36-yr-old woman with refractory myocardial dysfunction resulting from scombroid poisoning.


METHODS
Case report.


METHODS
Medical and surgical university care units.


METHODS
A previously healthy 36-yr-old woman with severe myocardial dysfunction unresponsive to epinephrine (1.3 microg/kg/min) and dobutamine (18 microg/kg/min) after the ingestion of cooked fresh tuna.


METHODS
Implantation at day 3 of a biventricular assist device consisting of two paracorporeal pneumatic pumps set at 70 beats/min to reach an output of 5.6 L/min during 8 days.


RESULTS
The biventricular mechanical circulatory assist device allowed weaning of the inotropic drugs, maintenance of end-organ function, and support of the patient until myocardial recovery. The patient was successfully explanted 11 days after ingestion. Cardiac function had totally recovered, but a stroke was noted. At 3-yrs follow-up, there was no cardiac or neurologic sequela.


CONCLUSIONS
This report describes severe myocardial dysfunction secondary to scombroid poisoning and demonstrates the usefulness of a mechanical circulatory assist device as a bridge to recovery.
Grinda
Jean-Michel
JM
Department of Cardio-Vascular Surgery, Hopital Europeen Georges Pompidou, Paris, France. jean-michel.grinda@egp.ap-hop-paris.fr
Bellenfant
Florence
F
Brivet
François Gilles
FG
Carel
Yvan
Y
Deloche
Alain
A
D000328:Adult; D005260:Female; D005517:Foodborne Diseases / Q000150:complications*; D006353:Heart-Assist Devices; D006801:Humans; D008387:Marine Toxins / Q000506:poisoning*; D012770:Shock, Cardiogenic / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy*
D008387:Marine Toxins; C034101:scombrotoxin