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Rescue of a child with fulminant myocarditis using percutaneous cardiopulmonary support
Y Inoue1, H Kaneko, Y Yoshizawa
1Department of Pediatrics, Gunma University School of Medicine, 3-39-15 Showa-machi, Maebashi, Gunma 371-8511, Japan.
Insights
Percutaneous cardiopulmonary support (PCPS) effectively treated a 14-year-old girl with severe fulminant myocarditis. This case highlights PCPS as a vital option for pediatric circulatory support in critical cardiac failure.
Area of Science:
- Pediatric Cardiology
- Critical Care Medicine
- Cardiovascular Surgery
Background:
- Fulminant myocarditis presents as severe, rapidly progressing cardiac failure in children.
- Standard treatments like inotropic support and mechanical ventilation may be insufficient for severe cases.
- Early intervention with advanced circulatory support is crucial for survival.
Observation:
- A 14-year-old female experienced a 3-week history of fatigue, fever, tachypnea, and dyspnea, progressing to critical cardiac failure.
- Despite inotropic support, mechanical ventilation, and intra-aortic balloon pumping, her condition deteriorated.
- Percutaneous cardiopulmonary support (PCPS) was initiated via a femoral artery/femoral vein approach.
Findings:
- PCPS led to rapid clinical improvement and hemodynamic stabilization in the patient.
- The successful application of PCPS demonstrated its efficacy in managing pediatric fulminant myocarditis.
- This intervention provided essential circulatory support during the acute phase of cardiac dysfunction.
Implications:
- PCPS is a viable and effective treatment strategy for children with fulminant myocarditis and refractory cardiac failure.
- This case supports the broader use of mechanical circulatory support in pediatric critical care.
- Further research into optimal PCPS management protocols for pediatric myocarditis is warranted.
Abstract:
This report describes a 14-year-old girl with fulminant myocarditis who was successfully treated with a percutaneous cardiopulmonary support (PCPS). She developed progressive cardiac failure after a 3-week history of progressive fatigue, fever, tachypnea, and dyspnea requiring inotropic support, mechanical ventilation, and intra-aortic balloon pumping. Her condition continued to deteriorate, and she was cannulated for PCPS using a right femoral artery/femoral vein approach, which resulted in rapid improvement and hemodynamic stabilization. This case documents that circulatory support with PCPS is effective for treating children with fulminant myocarditis.