Prolonged extracorporeal circulation for acute myocarditis

Total circulatory support for acute reversible myocardial failure is rarely used in clinical situations outside the postoperative period following cardiac surgery. We treated an 8-year-old girl who suffered acute viral myocarditis and sustained cardiac arrest requiring cardiopulmonary bypass for resuscitation. This was accomplished with the use of the portable cardiopulmonary support system (CPS), which consists of a centrifugal pump and a membrane oxygenator. This patient was placed on CPS in Hawaii and transported after 3 days to San Diego (4200 km) for further mechanical support and possible heart transplantation. Adequate cardiac function returned and CPS was stopped after 6 days. She is alive and well, attending school two and a half years after the event. Prolonged use of CPS for acute myocardial failure outside the operating room, including long distance transportation, is effective and easily accomplished with currently and widely available equipment, and should be used in acute, reversible catastrophic heart disease.