Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Management of Acute Fulminant Myocarditis Using a Left Ventricular Assist Device - A case report -

좌심실 보조장치를 이용한 전격성 심근염의 치료 - 1례 보고 -

  • Kang, Shin-Kwang (Department of Thoracic and Cardiovascular Surgery, College of Medicine, Chungnam National University) ;
  • Park, Sang-Soon (Department of Thoracic and Cardiovascular Surgery, College of Medicine, Chungnam National University) ;
  • Na, Myung-Hoon (Department of Thoracic and Cardiovascular Surgery, College of Medicine, Chungnam National University) ;
  • Yu, Jae-Hyeon (Department of Thoracic and Cardiovascular Surgery, College of Medicine, Chungnam National University) ;
  • Lim, Seung-Pyung (Department of Thoracic and Cardiovascular Surgery, College of Medicine, Chungnam National University) ;
  • Lee, Young (Department of Thoracic and Cardiovascular Surgery, College of Medicine, Chungnam National University) ;
  • Seong, In-Whan (Department of Internal Medicine, College of Medicine, Chungnam National University)
  • 강신광 (충남대학교 의과대학 흉부외과학교실) ;
  • 박상순 (충남대학교 의과대학 흉부외과학교실) ;
  • 나명훈 (충남대학교 의과대학 흉부외과학교실) ;
  • 유재현 (충남대학교 의과대학 흉부외과학교실) ;
  • 임승평 (충남대학교 의과대학 흉부외과학교실) ;
  • 이영 (충남대학교 의과대학 흉부외과학교실) ;
  • 성인환 (충남대학교 의과대학 내과학교실)
  • Published : 2001.06.01
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Abstract

A 17 year-old high school girl was admitted for anterior chest pain. Pulmonary edema and circulatory collapse progressed in spite of the medical treatment and intra-aortic balloon pump. Left ventricular assist device(LVAD, Bio-Pump, Medtronic Bio-Med, USA) was instituted under the impression of acute fulminant myocarditis. The inlet cannula was inserted in the left atrium(LA) via left submammary anterior thoracotomy. Biopsy was taken from left atrial appendage. The outlet cannula inserted to the left femoral artery using PTFE cuff. After 158 hours of extracorporeal circulation, LVAD was able to be weaned successfully with nearly normalized LV motion on echocardiogram, Coxsakievirus was identified with immunochemistry and serum neutralization test. She was discharged without any heart failure symptoms after 23 days of hopitalization.

17세 여자 고등학교 학생이 전흉부 동통을 주소로 입원하였다. 약물 치료와 대동맥내 풍선 펌프에도 불구하고 폐부종과 순환 허탈이 악화되었다. 급성 전격성 심근염 추정 진단 하에 좌심실 보조장치를 설치하였다. 유입구 도관은 유방하 좌전개흉술로 좌심이를 통하여 좌심방에 삽입하였고, 좌심이의 일부를 조직검사를 위해 떼어냈다. 유출구 도관은 좌측 대퇴 동맥에 PTFE도관을 간치시켜 삽입하였다. 체외순환 158시간 후 심초음파에서 좌심실의 운동성이 거의 정상으로 회복되었고, 좌심실 보조장치를 성공적으로 이탈할 수 있었다. 면역화학 검사와 중화 항체 검사에서 콕사키바이러스가 확인되었다. 환자는 입원 23일 째 아무런 심부전 증상없이 퇴원하였다.

Keywords

References

  1. Ann Thorac Surg v.69 Bridge to recovery with a left ventricular assist device for fulminant acute myocarditis Ueno T;Bergin P;Richardson M;Esmore DS
  2. Am J Cardiol v.82 Usefulness of extracorporeal membrane oxygenation for treatment of fulminant myocarditis and circulatory callapse Kawahito K;Murata S;Yasu T (et al)
  3. Z Kardiol v.86 Successful treatment of fulminant myocarditis with the biventricular MEDOS Assist System(MEDOS HIA-VAD) Martin J;Sarai K;Yoshitake M (et al)
  4. Ann Thorac Surg v.66 Circulatory support with pneumatic paracorporeal ventricular assist device in Hetzer R;Loebe M;Potapov EV (et al)
  5. Artif Organs v.20 Management of acute fulminant myocarditis using circulatory support systems Reiss N;el-Banayosy A;Posival H;Morshuis M;Minami K;Korfer R
  6. J Thorac Cardiovasc Surg v.113 Preoperative and postoperative comparison of patients with univentricular and biventricular support with Thoratec ventricular assist device as a bridge to cardiac transplantation Farrr D;Hill JD;Pennington DG (et al)
  7. 대흉외지 v.33 소아개심술 후 시행한 순환보조장치의 임상적 고찰 권오춘;이영탁