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Ann Thorac Surg 1995;59:749-751
© 1995 The Society of Thoracic Surgeons

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Articles

Transseptal decompression of the left heart during ECMO for severe myocarditis

Department of Pediatrics and Pediatric Surgery, Childrens Hospital of Oklahoma, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA

Accepted for publication July 8, 1994.

^* Address reprint requests to Dr Ward, PO Box 26307, Oklahoma City, OK 73126.

A 16-month-old boy suffered a cardiac arrest as a result of acute myocarditis, and venoarterial extracorporeal membrane oxygenation was instituted. Twelve hours later, acute left heart distention developed with cessation of left ventricular ejection. Under transesophageal echocardiographic guidance, a long introducer was placed into the left atrium through a transseptal puncture and connected in-line to the venous circuit. Within hours, left ventricular function improved and ejection returned. Left heart decompression was continued for 5 days, and the patient was weaned from extracorporeal membrane oxygenation after 6 days with normal cardiac and neurologic function.

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