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Extracorporeal life support can be a first-line treatment in children with acute fulminant myocarditis

 Se Yong Jung  ;  Hong Ju Shin  ;  Jo Won Jung  ;  Han Ki Park  ;  Yu Rim Shin  ;  Young Hwan Park  ;  Nam Kyun Kim  ;  Jae Young Choi 
 Interactive Cardiovascular and Thoracic Surgery, Vol.23(2) : 247-252, 2016 
Journal Title
 Interactive Cardiovascular and Thoracic Surgery 
Issue Date
Acute Disease ; Adolescent ; Child ; Child, Preschool ; Extracorporeal Membrane Oxygenation/methods* ; Female ; Humans ; Infant ; Male ; Myocarditis/diagnosis ; Myocarditis/therapy* ; Retrospective Studies ; Treatment Outcome
Children ; Extracorporeal life support ; Myocarditis
OBJECTIVES: The clinical outcome of children with severe acute myocarditis who require mechanical circulatory support is not well known. Therefore, we studied the survival and clinical courses of patients with acute fulminant myocarditis supported by extracorporeal life support (ECLS). METHODS: We performed a retrospective chart review of 13 consecutive children with acute fulminant myocarditis who were treated with ECLS between April 2013 and April 2015. Demographics, initial symptoms, laboratory results, management, clinical courses and last follow-up status were investigated. RESULTS: The median age was 25.8 months (range, 2.9 months to 11.5 years) and the median body weight was 10.3 kg (range, 5.3-47.5 kg). All patients received the ECLS procedure via peripheral approach (right neck). The median ECLS duration was 140 h (range, 51-425 h). The median intensive care unit stay was 16 days (range, 4-44 days). Viral pathogens were detected in 7 patients. Six patients underwent left-heart decompression using a catheter-based technique, which was performed using atrial septostomy and leaving a left atrial venting cannula. Eleven patients recovered from ventricular dysfunction, and 2 patients underwent successful orthotopic heart transplantation. Ultimately, 12 patients (92.3%) survived to discharge. The deceased patient succumbed to unrestored brain function due to enterovirus encephalitis, and the patient's parents chose to donate other organs. CONCLUSIONS: Mechanical circulatory support using ECLS can be a first-line treatment that confers excellent clinical outcomes for children with acute fulminant myocarditis.
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1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Nam Kyun(김남균)
Park, Young Hwan(박영환)
Park, Han Ki(박한기) ORCID logo https://orcid.org/0000-0002-7472-7822
Shin, Yu Rim(신유림)
Jung, Se Yong(정세용) ORCID logo https://orcid.org/0000-0003-1337-563X
Jung, Jo Won(정조원)
Choi, Jae Young(최재영) ORCID logo https://orcid.org/0000-0002-1247-6669
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