Left ventricular thrombosis caused cerebral embolism during venoarterial extracorporeal membrane oxygenation support: A case report  

作　　者：Yao-Bang Bai Feng Zhao Zhen-Hua Wu Guo-Ning Shi Nan Jiang 

机构地区：[1]Intensive Care Unit,Department of Cardiac Surgery,Tianjin Chest Hospital,Tianjin 300222,China [2]Department of Cardiac Surgery,Tianjin Chest Hospital,Tianjin 300222,China

出　　处：《World Journal of Clinical Cases》2024年第5期973-979,共7页世界临床病例杂志

基　　金：Supported by Tianjin Health Science and Technology Project,No.ZC20147.

摘　　要：BACKGROUND Venoarterial(VA)extracorporeal membrane oxygenation(ECMO),an effective short-term circulatory support method for refractory cardiogenic shock,is widely applied.However,retrospective analyses have shown that VA-ECMO-assisted cases were associated with a relatively high mortality rate of approximately 60%.Embolization in important organs caused by complications of left ventricular thrombosis(LVT)during VA-ECMO is also an important reason.Although the incidence of LVT during VA-ECMO is not high,the consequences of embolization are disastrous.CASE SUMMARY A 37-year-old female patient was admitted to hospital because of fever for 4 d and palpitations for 3 d.After excluding the diagnosis of coronary heart disease,we established a diagnosis of“clinically explosive myocarditis”.The patient still had unstable hemodynamics after drug treatment supported by VA-ECMO,with heparin for anticoagulation.On day 4 of ECMO support,a left ventricular thro-mbus attached to the papillary muscle root of the mitral valve was found by transthoracic echocardiography.Left ventricular decompression was performed and ECMO was successfully removed,but the patient eventually died of multiple cerebral embolism.CONCLUSION LVT with high mobility during VA-ECMO may cause embolism in important organs.Therefore,a"wait and see"strategy should be avoided.

关 键 词：Venoarterial extracorporeal membrane oxygenation Left ventricular thrombosis Cerebral embolism Magnetic Resonance Imaging THERAPY Case report 

分 类 号：R576[医药卫生—消化系统]