Successful Treatment of Severe Intractable Diarrhea and Malnutrition in a Child with Dilated Cardiomyopathy Bridged to Left Ventricular Assist Device from Extracorporeal Cardiopulmonary Resuscitation

Abstract

An increasing number of pediatric patients with dilated cardiomyopathy (DCMP) undergo mechanical circulatory support (MCS), as a bridge to heart transplantation. Gastrointestinal complications in this population are rare, and the treatment is challenging. Patients with DCMP frequently present with heart failure symptoms, such as tachycardia, hypotension, respiratory distress, cyanosis, weak peripheral pulses, and inadequate feed. Rarely, gastrointestinal symptoms, such as nausea and ascites, may be noted if biventricular failure develops. Here we present a case of a 14-year-old girl with severe intractable diarrhea and malnutrition after being diagnosed with DCMP. After extracorporeal cardiopulmonary resuscitation, she was bridged to a long-term left ventricular assist device support. Her recovery was complicated with intractable diarrhea and malnutrition, which were critical. Thus, this case study aimed to emphasize that pediatric patients with DCMP having persistent diarrhea and malnutrition can be successfully treated with MCS.

Keywords

• dilated cardiomyopathy
• intractable diarrhea
• malnutrition
• extracorporeal membrane oxygenation
• left ventricular assist device