A Successful Case of Central ECMO with a Transapical Left Ventricular Vent for Fulminant Myocarditis

Kaori Mori＊	Motohiko Goda＊	Taisuke Shibuya＊
Norihisa Tominaga＊	Daisuke Machida＊	Yukihisa Isomatu＊
Shinichi Suzuki＊	Munetaka Masuda＊

（Department of Cardiovascular Surgery, Yokohama City University Hospital＊, Yokohama, Japan）

We report a successful case of fulminant myocarditis treated with central ECMO with a transapical left ventricular vent（TLVV). A 33-year-old man was diagnosed with fulminant myocarditis with acute biventricular failure. Using a cardio-pulmonary bypass, we introduced central ECMO with ascending aortic perfusion, right atrial venous drainage and TLVV. After ancillary circulation, his cardiac function gradually improved. The endotracheal tube was removed 5 days after the surgery（POD5), and he was weaned from ECMO on POD 7 and discharged on POD 38. Although there are many cases in which peripheral veno-arterial ECMO（VA-ECMO）is used for fulminant myocarditis, there is a drawback to VA-ECMO:left ventricle（LV）unloading may be incomplete. Insufficient LV unloading may cause pulmonary congestion or disadvantage in myocardial recovery. TLVV can be used as a solution to unload the left ventricle. Central ECMO with TLVV should be useful therapy for fulminant myocarditis.

 

Jpn. J. Cardiovasc. Surg. 49:106-109（2020）

Keywords：fulminant myocarditis;central ECMO;transapical left ventricular vent（TLVV）;LV unloading