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Venoarterial extracorporeal membrane oxygenation and implantable cardioverter-defibrillator implantation in a hemodynamically unstable infant with ventricular tachycardia from multiple cardiac rhabdomyomas

Introduction Tuberous sclerosis complex (TSC) is a neurocutaneous disorder characterized by benign tissue hamartomas in multiple organ systems, including cardiac rhabdomyomas. Though prevalent in TSC, cardiac tumors are rare in… Click to show full abstract

Introduction Tuberous sclerosis complex (TSC) is a neurocutaneous disorder characterized by benign tissue hamartomas in multiple organ systems, including cardiac rhabdomyomas. Though prevalent in TSC, cardiac tumors are rare in children, occurring in about 0.03%–0.17%. Rhabdomyomas are the most common, accounting for 45%. When present, they are multiple and in the ventricular myocardium. Frequently, they regress and surveillance is all that is required until spontaneous regression. Intervention is necessary when lifethreatening obstruction or hemodynamically significant refractory arrhythmias occur. This case highlights the course of a 6-month-old infant with TSC and cardiac rhabdomyomas who presented in refractory ventricular tachycardia (VT) with decompensation and cardiac arrest necessitating venoarterial extracorporeal membrane oxygenation (VA-ECMO), complex antiarrhythmic therapy, and ultimately implantable cardioverter-defibrillator (ICD) implantation.

Keywords: rhabdomyomas; venoarterial extracorporeal; ventricular tachycardia; extracorporeal membrane; membrane oxygenation; cardiac rhabdomyomas

Journal Title: HeartRhythm Case Reports
Year Published: 2019

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