Initiation of extracorporeal membrane oxygenation may increase left ventricular volume, pressure and wall stress. Left atrial decompression may reduce ventricular wall stress and filling pressures, thus improving coronary perfusion. This may contribute to ventricular functional recovery.
The pediatric experience consists mainly of postoperative congenital heart disease patients. Scarce reports exist about neonates on extracorporeal membrane oxygenation due to other acute cardiac causes. We present a neonate with fulminant myocarditis with severe pulmonary edema upon extracorporeal membrane oxygenation initiation, which improved almost instantly after atrial decompression.