Neonatal myocardial infarction and the role extracorporeal membrane oxygenation(ECMO)

Abstract

Myocardial infarction is rarely seen in newborns, but is probably under-recognised. In older children, failure of medical support for myocardial failure warrants the use of circulatory assist devices which may permit myocardial recovery. Four neonates with circulatory collapse from acute myocardial infarction have presented to us over the last 5 years. Three were supported with ECMO and cardiac surgery and one was managed with maximal medical therapy. One infant had support withdrawn for severe lack of viable myocardium, but the other three have survived and are doing well up to five years later. Prospects for myocardial regeneration are good in the neonate. Prompt recognition of infarction and appropriate medical support may suffice, but a low threshold for ECMO referral is recommended.