TRANSSEPTAL DECOMPRESSION OF THE LEFT-HEART DURING ECMO FOR SEVERE MYOCARDITIS

A 16-month-old boy suffered a cardiac arrest as a result of acute myoc arditis, and venoarterial extracorporeal membrane oxygenation was inst ituted. Twelve hours later, acute left heart distention developed with cessation of left ventricular ejection. Under transesophageal echocar diographic guidance, a long introducer was Placed into the left atrium through a transseptal puncture and connected in-line to the venous ci rcuit. Within hours, left ventricular function improved and ejection r eturned. Left heart decompression was continued for 5 days, and the pa tient was weaned from extracorporeal membrane oxygenation after 6 days with normal cardiac and neurologic function.