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Central extracorporeal membrane oxygenation with left-ventricular vent for fulminant myocarditis: a retrospective study

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  • Artificial Lung / ECMO
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Abstract

Purpose

Fulminant myocarditis presents as acute severe heart failure and requires mechanical cardiocirculatory support. Left-ventricular (LV) decompression is necessary for the successful recovery of these patients. This retrospective study aimed to evaluate the functional outcomes of providing central extracorporeal membrane oxygenation (ECMO) with LV decompression for the treatment of refractory fulminant myocarditis.

Methods

Between January 2015 and February 2021, seven consecutive fulminant myocarditis patients (mean age: 41.1 ± 26.1 years) received central ECMO support with transapical LV decompression, with an 18 French cannula integrated into the ECMO circuit in a Y-fashion. The baseline characteristics and postoperative outcomes of the patients were collected.

Results

On admission, all patients received prior peripheral ECMO, and 85.7% (6/7) of patients received prior intra-aortic balloon pumping. However, all patients had refractory cardiogenic shock that failed prior to decompression. Six patients recovered successfully after a mean ECMO support of 20.0 ± 11.5 days and five patients had no recurrence of cardiac decompensation. The mean ICU and mean hospital stays were 36.7 ± 23.5 days and 60.6 ± 24.9 days, respectively. Hospital mortality was 28.6% (2/7). Two patients died due to sepsis and stroke during hospitalization.

Conclusions

Central ECMO with an LV vent was effective for fulminant myocarditis refractory to percutaneous cardiopulmonary support therapy and other therapies.

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References

  1. Lucas SK, Schaff HV, Flaherty JT, Gott VL, Gardner TJ. The harmful effects of ventricular distention during postischemic reperfusion. Ann Thorac Surg. 1981;32:486–94.

    Article  CAS  PubMed  Google Scholar 

  2. Schwarz B, Mair P, Margreiter J, et al. Experience with percutaneous venoarterial cardiopulmonary bypass for emergency circulatory support. Crit Care Med. 2003;31:758–64.

    Article  PubMed  Google Scholar 

  3. Lorusso R, Centofanti P, Gelsomino S, et al. Venoarterial extracorporeal membrane oxygenation for acute fulminant myocarditis in adult patients: a 5-year multi-institutional experience. Ann Thorac Surg. 2016;101:919–26.

    Article  PubMed  Google Scholar 

  4. Reymond P, Bendjelid K, Giraud R, et al. To balloon or not to balloon? The effects of an intra-aortic balloon-pump on coronary artery flow during extracorporeal circulation simulating normal and low cardiac output syndromes. J Clin Med. 2021;10:5333.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Hasde Aİ, Sarıcaoğlu MC, Dikmen Yaman N, et al. Comparison of left ventricular unloading strategies on venoarterial extracorporeal life support. Interact Cardiovasc Thorac Surg. 2020. https://doi.org/10.1093/icvts/ivaa284.

    Article  PubMed Central  Google Scholar 

  6. Tschöpe C, Van Linthout S, Klein O, et al. Mechanical unloading by fulminant myocarditis: LV-IMPELLA, ECMELLA, BI-PELLA, and PROPELLA concepts. J Cardiovasc Transl Res. 2019;12:116–23.

    Article  PubMed  Google Scholar 

  7. Dixon SR, Henriques JPS, Mauri L, et al. A prospective feasibility trial investigating the use of the impella 2.5 system in patients undergoing high-risk percutaneous coronary intervention (The PROTECT I Trial) initial U.S. experience. JACC Cardiovasc Interv. 2009;2:91–6.

    Article  PubMed  Google Scholar 

  8. Seeker-Walker JS, Edmonds JF, Spratt EH, Conn AW. The source of coronary perfusion during partial bypass for extracorporeal membrane oxygenation (ECMO). Ann Thorac Surg. 1976;21:138–43.

    Article  Google Scholar 

  9. Cheng R, Hachamovitch R, Kittleson M, et al. Clinical outcomes in fulminant myocarditis requiring extracorporeal membrane oxygenation: a weighted meta-analysis of 170 patients. J Card Fail. 2014;20:400–6.

    Article  PubMed  Google Scholar 

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Acknowledgements

We would like to thank Editage [http://www.editage.com] for editing and reviewing this manuscript for English language

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Authors and Affiliations

  1. Division of Cardiovascular Surgery, Department of Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, Nagano, 390-8621, Japan

    Masaki Komatsu, Kazuki Naito, Shuji Chino, Haruki Tanaka, Hajime Ichimura, Takateru Yamamoto, Ko Nakahara, Megumi Fuke, Yuko Wada & Tatsuichiro Seto

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  1. Masaki Komatsu
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  2. Kazuki Naito
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  3. Shuji Chino
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  4. Haruki Tanaka
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  5. Hajime Ichimura
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  6. Takateru Yamamoto
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  7. Ko Nakahara
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  8. Megumi Fuke
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  9. Yuko Wada
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  10. Tatsuichiro Seto
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by MK. The first draft of the manuscript was written by MK and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Tatsuichiro Seto.

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Komatsu, M., Naito, K., Chino, S. et al. Central extracorporeal membrane oxygenation with left-ventricular vent for fulminant myocarditis: a retrospective study. J Artif Organs 26, 297–302 (2023). https://doi.org/10.1007/s10047-022-01371-y

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  • DOI: https://doi.org/10.1007/s10047-022-01371-y

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