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J Thorac Cardiovasc Surg 2003;126:885-886
© 2003 The American Association for Thoracic Surgery

Brief communications

Successful LVAS and RVAS-ECMO support in a patient with fulminant myocarditis who failed to recover from ventricular fibrillation with PCPS and IABP

Satoshi Gojoa, Shunei Kyoa,b,*, Hiroshige Satoa, Motonobu Nishimurab, Toshihisa Asakuraa, Hiroyuki Itoc, Kaoru Koyama,d

a Department of Cardiovascular Surgery, Saitama Medical Center, Saitama, Japan
b Department of Cardiovascular Surgery, Saitama Medical School, Saitama, Japan
c Third Department of Internal Medicine, Saitama Medical Center, Saitama, Japan
d Department of Anesthesiology, Saitama Medical Center, Saitama, Japan

Received for publication February 17, 2003; accepted for publication March 25, 2003.

* Address for reprints: Shunei Kyo, MD, PhD, Department of Cardiovascular Surgery, Saitama Medical Center, 1981 Kamoda, Kawagoe, Saitama 350-8550, Japan
eikyo501@saitama-med.ac.jp

The first 20% of the full text of this article appears below.

Fulminant myocarditis can cause sudden circulatory collapse due to lethal arrhythmia, which is resistant to conventional treatments such as percutaneous cardiopulmonary support (PCPS) and intra-aortic balloon pumping (IABP). We describe the case of a young patient with fulminant end-stage myocarditis who was unable to recover from ventricular fibrillated (Vf) cardiac condition even with PCPS and IABP and who achieved recovery using a left ventricular assist system (LVAS) and a right ventricular assist system (RVAS) with extracorporeal membrane oxygenation (ECMO).

Clinical summary

Myocarditis remains a poorly characterized disorder, and it is sometimes difficult to make an early diagnosis.1 Although patients with fulminant myocarditis (FM) have a better long-term prognosis than those with acute (nonfulminant) myocarditis,2 rapid progressive cardiac decompensation in FM soon after diagnosis may be obstinate. The usefulness of PCPS in treating patients with myocarditis who develop cardiogenic shock has been documented.3 In cases of exacerbation of multiple organ failure, low flow of PCPS, long-term usage of PCPS, trouble with PCPS cannula, and sustained Vf, the implantation . . . [Full Text of this Article]






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