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Prolonged extracorporeal circulation for acute myocarditis
C E Moreno-Cabral1, R J Moreno-Cabral, J J McNamara
1University of Hawaii John A. Burns School of Medicine, Honolulu.
The International Journal of Artificial Organs
|August 1, 1992
Summary
Portable cardiopulmonary support (CPS) effectively treated a child with acute myocarditis and cardiac arrest. This life-saving technology enabled long-distance transport and recovery, demonstrating its value for reversible heart failure outside the operating room.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Surgery
- Critical Care Medicine
Background:
- Acute myocardial failure, particularly in children, presents significant clinical challenges.
- Total circulatory support is seldom utilized outside the immediate postoperative cardiac surgery setting.
Observation:
- An 8-year-old girl experienced acute viral myocarditis leading to cardiac arrest.
- She required cardiopulmonary bypass for resuscitation and stabilization.
- A portable cardiopulmonary support (CPS) system, including a centrifugal pump and membrane oxygenator, was employed.
Findings:
- The patient was successfully managed on CPS for 3 days in Hawaii before transport to San Diego (4200 km) for continued mechanical support.
- Adequate cardiac function was restored, allowing for discontinuation of CPS after 6 days.
- The patient has shown sustained recovery and remains well two and a half years post-event.
Implications:
- Portable cardiopulmonary support is a viable and effective option for managing acute, reversible catastrophic heart disease in pediatric patients.
- This technology facilitates prolonged mechanical circulatory support and inter-facility transport, expanding treatment possibilities beyond the operating room.
- The successful application of CPS in this case highlights its potential for broader clinical use in critical cardiac conditions.