초록접수 현황
| 20F-078 | 포스터 발표 |
A Patient with Acute Fulminant Myocarditis Survives After Prolonged ECMO Support: A Case Report
Jeong In Hong, Jae Seung Shin, Hong Ju Shin
Department of Thoracic and Cardiovascular Surgery, Korea University Ansan Hospital, Korea University College of Medicine, Korea.
Purpose : While some patients with fulminant myocarditis can be bridged to recovery, heart transplantation may be considered in those who cannot wean off from mechanical circulatory support. The timing of making such a decision remains challenging. We report a case of acute FM successfully treated with venoarterial extracorporeal membrane oxygenation (VA-ECMO) support.
Results : A 32-year-old female patient in complaint of fever and myalgia was admitted and started on medical treatment under the impression of acute myocarditis. Although the initial chest x-ray and echocardiogram were nonspecific with ejection fraction preserved at 60 – 65%, the patient’s condition deteriorated over the next five days and the VA-ECMO cannulation was performed. The patient was listed for heart transplantation. On the sixth day of ECMO support, the transvenous venting cannula was placed for left atrial decompression. There were matching donors in the following weeks, but the patient and her family turned down the opportunities and decided to wait for her native heart to recover. Sacubitril/valsartan (100mg, every 12 h) administration was initiated on the eighteenth day of ECMO support. Over the next weeks, the heart’s contractility improved on serial echocardiograms, and the patient was successfully weaned off from ECMO on day 34 of the support and transferred to a general ward with low dose IV dopamine, which gradually tapered off. Her total length of hospital stay was 65 days. Four months later on her last outpatient visit, the ejection fraction was increased to 43% and the patient was symptom-free.
Results : A 32-year-old female patient in complaint of fever and myalgia was admitted and started on medical treatment under the impression of acute myocarditis. Although the initial chest x-ray and echocardiogram were nonspecific with ejection fraction preserved at 60 – 65%, the patient’s condition deteriorated over the next five days and the VA-ECMO cannulation was performed. The patient was listed for heart transplantation. On the sixth day of ECMO support, the transvenous venting cannula was placed for left atrial decompression. There were matching donors in the following weeks, but the patient and her family turned down the opportunities and decided to wait for her native heart to recover. Sacubitril/valsartan (100mg, every 12 h) administration was initiated on the eighteenth day of ECMO support. Over the next weeks, the heart’s contractility improved on serial echocardiograms, and the patient was successfully weaned off from ECMO on day 34 of the support and transferred to a general ward with low dose IV dopamine, which gradually tapered off. Her total length of hospital stay was 65 days. Four months later on her last outpatient visit, the ejection fraction was increased to 43% and the patient was symptom-free.
책임저자: Hong Ju Shin
Department of Thoracic and Cardiovascular Surgery, Korea University Ansan Hospital, Korea University College of Medicine, Korea.
발표자: Jeong In Hong, E-mail : jeonginhannahh@gmail.com