Severe Fetal Cardiomyopathy: Considerations for Extracorporeal Cardiopulmonary Resuscitation During Neonatal Resuscitation

Primary cardiomyopathies are associated with poor neonatal outcomes, including high mortality rates. Neonatal care of infants with significant prenatal cardiac diagnoses may warrant additional management considerations beyond standard Neonatal Resuscitation Program guidelines. Many of these management considerations are described in the Neonatal Resuscitation, 9th Edition, which details several congenital cardiac lesions and their delivery room management; still, a prenatal primary cardiomyopathy diagnosis warrants additional, unique predelivery care planning, especially in more severe cases. This case report describes our multidisciplinary team's approach to predelivery planning and neonatal resuscitation and stabilization of an infant with prenatal diagnosis of severe cardiomyopathy. The case underscores that with continued refinement in patient selection, timing, and technology, a similar approach undertaken in a future case might yield a favorable outcome.