Critical Intraoperative Detection of Microbubbles in Veno-Veno-Arterial ECMO Support With Impella: A Case Report of Peripartum COVID-19 Myocarditis.

Critical Intraoperative Detection of Microbubbles in Veno-Veno-Arterial ECMO Support With Impella: A Case Report of Peripartum COVID-19 Myocarditis.

Publication date: Sep 01, 2025

Microbubbles during extracorporeal membrane oxygenation (ECMO) can cause systemic embolism. We report a 33-year-old woman in late pregnancy with COVID-19-associated myocarditis supported by veno-veno-arterial ECMO and Impella 5. 5. During rapid transfusion via central venous catheter for massive hemorrhage after emergency cesarean section, transesophageal echocardiography (TEE) revealed microbubbles entering the arterial circulation. The bubbles resolved after pausing transfusion. Although the patient initially recovered without neurological deficits, she later died from unrelated intracranial hemorrhage. This case highlights the need to prevent air entrainment during transfusion and illustrates the diagnostic value of intraoperative TEE in detecting systemic microembolism under mechanical circulatory support.

Concepts Keywords
Covid Arterial
Echocardiography Covid
Hemorrhage Critical
Microbubbles Detection
Pregnancy Ecmo
Hemorrhage
Impella
Intraoperative
Microbubbles
Myocarditis
Peripartum
Systemic
Tee
Transfusion
Veno

Semantics

Type Source Name
disease MESH COVID-19
disease MESH Myocarditis
disease MESH embolism
disease MESH hemorrhage
disease MESH emergency
disease MESH intracranial hemorrhage
drug DRUGBANK Medical air

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