Transplant & MCSThursday, October 15, 2026

Extracorporeal Cardiopulmonary Resuscitation as a Bridge to Cardiac Transplantation in Refractory Cardiac Arrest Due to Fulminant Myocarditis: A Case Report.

1 min read·By E. Nolan Beckett, MD·Source: International medical case reports journal

From The Cardiac Wire

Durable LVAD outcomes in Japan improved substantially with HeartMate 3, and the residual failure modes are right-sided.

The third J-MACS report, 1,859 patients from 2011 to 2025 , shows 5-year survival of 84% in the post-2019 era versus 76% before, with significant gains in freedom from pump thrombosis, stroke, major bleeding, and pump exchange.

Editor’s take pending for this article; this is the section commentary excerpt.

Source Abstract

Extracorporeal cardiopulmonary resuscitation (ECPR) is increasingly used for refractory cardiac arrest, although evidence for a survival benefit remains heterogeneous and appears highly dependent on patient selection and systems of care. We report the case of a previously healthy 36-year-old woman who presented with acute fulminant myocarditis and cardiogenic shock. Following an in-hospital cardiac arrest unresponsive to conventional cardiopulmonary resuscitation, bedside ECPR was initiated using peripheral veno-arterial extracorporeal membrane oxygenation (VA-ECMO) as a bridge to longer-term mechanical circulatory support with a biventricular assist device (BiVAD). After conversion to central BiVAD support, the patient was listed super-urgently and subsequently underwent successful donation-after-circulatory-death heart transplantation. She was discharged home neurologically intact and remains well five months after discharge. This case demonstrates that when deterioration is imminent and standard therapies have failed, ECPR may provide life-saving support while preparing for definitive mechanical circulatory support, even when most members of the clinical team lack ECPR experience. Timely leadership and coordinated multidisciplinary expertise were the key to achieving a successful outcome in this case.