A 68-year-old male, who was diagnosed as fulminant myocarditis was transferred to
our hospital. After admission, intra-aortic balloon pumping (IABP) and percutaneous
cardiopulmonary support (PCPS) were introduced due to cardiogenic shock. The 3rd day,
echocardiography revealed continuous closure of the aortic valve and spontaneous echo
contrast on that. LV vent catheter was inserted to avoid severe pulmonary edema and
irreversible LV dysfunction. After 19 days of cardiopulmonary support, His cardiac
function improved gradually and he weaned from PCPS. After a termination of deep sedation,
Right hemiparesis was appeared and brain CT revealed multiple cerebral infarction.
Thrombus on the valve was considered to be the cause of cerebral infarction. This
case suggests that the aortic valve opening is important to avoid thromboembolic complications
in patients with fulminant myocarditis under PCPS.
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