Extracorporeal membrane oxygenation for children with fulminant myocarditis

The purpose of this study was to evaluate the outcomes of children requiring extracorporeal membrane oxygenation for acute myocarditis. The hospital records of 8 patients who underwent membrane oxygenation for myocarditis from January 2002 to October 2008 were reviewed. Ages ranged from 3 to 12 years (median, 6 years). Duration of membrane oxygenation ranged from 89-502 h. Two patients who collapsed and required cardiac massage prior to membrane oxygenation did not survive. Five (62.5%) patients were discharged well, but one developed dilated cardiomyopathy and died 18 months later. One child had severe mitral regurgitation after weaning from membrane oxygenation, and underwent successful mitral valve repair. Another patient had no cardiac contractility for the initial 2 weeks, but regained good cardiac function after 21 days of support. She was weaned off membrane oxygenation and discharged home well. Complications included left hemiparesis in one patient and left hemothorax in 2. Recovery of cardiac function and a good outcome can be anticipated in children with acute myocarditis requiring membrane oxygenation. Initiation of membrane oxygenation before cardiovascular collapse increases the likelihood of survival.