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机械循环支持下的心移植治疗暴发性心肌炎:一例报告。

Heart transplantation under mechanical circulatory support for fulminant myocarditis: a Case Report.

机构信息

Department of Cardiac Surgery, Zhongshan Hospital, Fudan University, No. 180 Fenglin Rd, Shanghai, 200032, China.

出版信息

J Cardiothorac Surg. 2024 Aug 24;19(1):491. doi: 10.1186/s13019-024-02999-y.

Abstract

Fulminant myocarditis has been defined as the clinical manifestation of cardiac inflammation with rapid-onset heart failure and cardiogenic shock. We report on the case of a 17-year-old boy with hemodynamic derangement and cardiac arrest due to fulminant myocarditis. After about 2 h of intensive cardiopulmonary resuscitation, with 13 days of extracorporeal membrane oxygenation support, the patient finally bridged to orthotopic heart transplantation. The patient recovered uneventfully and was discharged 37 days after transplantation. The explanted heart revealed diffuse lymphocytic infiltration and myocyte necrosis in all four cardiac chamber walls confirming the diagnosis and identifying the underlying cause of fulminant myocarditis.

摘要

暴发性心肌炎定义为伴有心力衰竭和心源性休克的快速发作性心脏炎症的临床表现。我们报告了一例因暴发性心肌炎导致血流动力学紊乱和心搏骤停的 17 岁男孩病例。经过大约 2 小时的强化心肺复苏,并使用了 13 天的体外膜氧合支持,患者最终成功过渡到原位心脏移植。患者恢复顺利,在移植后 37 天出院。所取出的心脏显示四个心腔壁均有弥漫性淋巴细胞浸润和心肌坏死,明确了暴发性心肌炎的诊断和病因。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/adcb/11344289/9d236102662a/13019_2024_2999_Fig1_HTML.jpg

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