Abstract
Giant cell myocarditis (GCM) is a rare and commonly fatal form of fulminant myocarditis. During the acute phase, while immunosuppressive therapy is initiated, venoarterial extracorporeal membrane oxygenation (VA-ECMO) support is commonly used as a bridge to heart transplantation or recovery. Until recently, conventional transesophageal echocardiography and transthoracic echocardiography were the tools available for hemodynamic assessment of patients on this form of mechanical circulatory support. Nevertheless, both techniques have their limitations. We present a case of a 54-year-old man diagnosed with GCM requiring VA-ECMO support that was monitored under a novel miniaturized transesophageal echocardiography (hTEE) probe recently approved for 72 hours of continuous hemodynamic monitoring. Our case highlights the value of this novel, flexible, and disposable device for hemodynamic monitoring, accurate therapy guidance, and potential VA-ECMO weaning process of patients with this form of severe myocarditis.
Highlights
Giant cell myocarditis (GCM) is a rare clinical condition characterized by rapid compromise of cardiac systolic function, leading to severe cardiogenic shock
No current guidelines are available for an optimal monitoring device for patients under extracorporeal membrane oxygenation (ECMO) support, conventional transesophageal echocardiography (TEE) or transthoracic echocardiography (TTE) is commonly used for this purpose [3]
GCM under venoarterial extracorporeal membrane oxygenation (VA-ECMO) support monitored with a novel, miniaturized, flexible, and disposable hemodynamic transesophageal echocardiography probe that allows for 72 hours of continuous hemodynamic monitoring
Summary
Giant cell myocarditis (GCM) is a rare clinical condition characterized by rapid compromise of cardiac systolic function, leading to severe cardiogenic shock It has a grave prognosis with a rate of death or heart transplantation of 70% at 1 year. No current guidelines are available for an optimal monitoring device for patients under extracorporeal membrane oxygenation (ECMO) support, conventional transesophageal echocardiography (TEE) or transthoracic echocardiography (TTE) is commonly used for this purpose [3]. Both techniques have limitations [4, 5]. GCM under VA-ECMO support monitored with a novel, miniaturized, flexible, and disposable hemodynamic transesophageal echocardiography (hTEE) probe that allows for 72 hours of continuous hemodynamic monitoring
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