Abstract
Yasuhide Asaumi, Satoshi Yasuda, lsao Morii, Hiroyuki Kakuchi, Yoritaka Otsuka, Atsushi Kawamura, Hiroshi Nonogi, Yoshikado Sasako, Shunichi Miyazaki, National Cardiovascular Center, Suita, Japan Background: The application of extracorporeal membrane oxygenation (ECMO) wtth percutaneous cardiopulmonary bypass has been recently extended to temporaiy circula- tory support in patients with fulminant myocarditis. However, the survival and prognosis of patients who are particularly ill remain poorly understood. Methods: Patients with myocarditis were divided into the following two groups. Fourteen patients who required ECMO for cardiogenic shock were defined as having fulminant myocarditis (F group), whereas 13 patients who had acute onset of symptoms but did not have compromised hemodynamics were defined as having acute (nonfulminant) myocarditis (non-F group). Results: In F group, 10 patients were successfully weaned from ECMO. Therefore, the overall survival rate at the time of discharge was 71%. Between patients who died (D) and those survived (S) in F group. there were significant differences (PcO.05) in left ven- tricular end-diastolic dimension (D:36& vs S:50*2 [mean&EM] mm), end-systolic dimension (D:34+6 vs S:45+2mm), wall thickness (D:15+1 vs S:l lilmm). maxCPK-MB levels (D:353*145 vs S:120+35U/L) and serum creatinine levels (D:2.1*0.5 vs S:l.O+O.lmg/dl). Compared with the non-F group, the fractional shortening in the F group was more severely depressed in the acute phase (F:lOil vs non-F:23*3%, P<O.O5), but recovered in the chronic phase (F:30*2 vs non-F:33*3%, P=NS). Rates for adverse clin- ical events were also similar between the F and non-F groups during the follow-up period of 36 months on average. Conclusions: In patients with fulminant myocarditis, a hemo- dynamic support using ECMO results in excellent swival. Once a patient recovers from inflammatory myocardial damage, the subsequent clinical outcome is favorable, similar to that observed in patients with acute (nonfulminant) myocardltis. 1208-66
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
