Early and late outcome of 527 consecutive patients treated with extracorporeal membrane oxygenation for refractory postcardiotomy cardiogenic shock (PCS)

Rastan, A; Dege, Andreas; Mohr, Matthias; Doll, N.; Walther, T; Lehmann, Sven; Falk, Volkmar; Mohr, FW

doi:10.1055/s-0029-1191494

Cited by 40 publications

(79 citation statements)

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“…In fact, the reported in-hospital survival has ranged from 24.8% to 52% in several case series, a 1-year survival ranging from 16.5% to 47.6% and gradually ranging from almost 10% to 37% when the late survival is considered (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30). These data clearly show how the majority of PC-ECMO patients die during the hospitalization, showing a fall in the mortality rate after being discharged.…”

Section: Discussionmentioning

confidence: 77%

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Long-term survival and major outcomes in post-cardiotomy extracorporeal membrane oxygenation for adult patients in cardiogenic shock

Meani¹,

Matteucci²,

Jiritano³

et al. 2019

Ann. Cardiothorac. Surg.

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Extracorporeal membrane oxygenation (ECMO) in the veno-arterial (VA) configuration is an established method for the treatment of refractory cardiogenic shock. Such a condition characterizes the postoperative course of approximatively 1% of cardiac surgery patients. Although some studies have reported ECMOrelated short-term results, little is known about the long-term outcomes of VA-ECMO therapy in the postcardiotomy setting. Therefore, an extensive literature search was conducted regarding articles published after 1990 reporting postoperative ECMO use. PubMed, EMBASE and Web of Science were searched for sources. In-hospital mortality was high in post-cardiotomy VA-ECMO patients, ranging from 24.8% to 52%. Long-term results were poorly reported. However, based on the limited information available, hospital survivors showed a favorable outcome, with improvement in overall clinical condition, quality of life and limited hospital readmission for cardiac-related events. To conclude, in-hospital outcome in post-cardiotomy ECMO is often unfavorable, post-discharge results show satisfactory condition, with stable improvement of overall patient clinical status and low rate of hospital readmission and cardiac-related adverse events. Data reporting is, however, scarce and hence new and detailed studies are still warranted to investigate such aspects.

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Section: Discussionmentioning

confidence: 77%

“…The incidence of refractory PCS in adult cardiac surgical patients ranges from 0.5% to 1.5% (24,31,32). PCS is a rare but dreadful complication.…”

Section: Discussionmentioning

confidence: 99%

Long-term survival and major outcomes in post-cardiotomy extracorporeal membrane oxygenation for adult patients in cardiogenic shock

Meani¹,

Matteucci²,

Jiritano³

et al. 2019

Ann. Cardiothorac. Surg.

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“…Potential benefits of MCS include the ability to: (1) maintain vital organ perfusion, thereby preventing systemic shock syndrome, (2) reduce intracardiac filling pressures, thereby reducing congestion and/or pulmonary edema, (3) reduce left ventricular volumes, wall stress, and myocardial oxygen consumption, (4) augment coronary perfusion, (5) support the circulation during complex interventional and electrophysiologic procedures, and, theoretically, (6) limit infarct size. As new MCS devices become available, several specific patient populations likely to benefit from this therapy can be identified.…”

Section: Clinical Settings and Hemodynamic Substratesmentioning

confidence: 99%

2015 SCAI/ACC/HFSA/STS Clinical Expert Consensus Statement on the Use of Percutaneous Mechanical Circulatory Support Devices in Cardiovascular Care (Endorsed by the American Heart Association, the Cardiological Society of India, and Sociedad Latino Americana de Cardiologia Intervencion; Affirmation of Value by the Canadian Association of Interventional Cardiology–Association Canadienne de Cardiologie d'intervention)∗

Rihal

Naidu

Givertz

et al. 2015

Journal of Cardiac Failure

246

319

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Although historically the intra-aortic balloon pump has been the only mechanical circulatory support device available to clinicians, a number of new devices have become commercially available and have entered clinical practice. These include axial flow pumps, such as Impella(®); left atrial to femoral artery bypass pumps, specifically the TandemHeart; and new devices for institution of extracorporeal membrane oxygenation. These devices differ significantly in their hemodynamic effects, insertion, monitoring, and clinical applicability. This document reviews the physiologic impact on the circulation of these devices and their use in specific clinical situations. These situations include patients undergoing high-risk percutaneous coronary intervention, those presenting with cardiogenic shock, and acute decompensated heart failure. Specialized uses for right-sided support and in pediatric populations are discussed and the clinical utility of mechanical circulatory support devices is reviewed, as are the American College of Cardiology/American Heart Association clinical practice guidelines.

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“…The survival outcomes were favorable in our study compared with those for other VAD cohorts in postcardiotomy settings. 19,20 Perhaps the early restoration of the hemodynamics prevented the installation of irreversible end organ dysfunction, which led to greater survival. In the present study, Impella support was initiated promptly when the patient experienced hemodynamic compromise despite inotropic support.…”

Section: Significantly Thus In Consultation With the Food And Drugmentioning

confidence: 99%

The RECOVER I: A multicenter prospective study of Impella 5.0/LD for postcardiotomy circulatory support

Griffith

Anderson

Samuels

et al. 2013

The Journal of Thoracic and Cardiovascular Surgery

193

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Early and late outcome of 527 consecutive patients treated with extracorporeal membrane oxygenation for refractory postcardiotomy cardiogenic shock (PCS)

Cited by 40 publications

References 0 publications

Long-term survival and major outcomes in post-cardiotomy extracorporeal membrane oxygenation for adult patients in cardiogenic shock

Long-term survival and major outcomes in post-cardiotomy extracorporeal membrane oxygenation for adult patients in cardiogenic shock

The RECOVER I: A multicenter prospective study of Impella 5.0/LD for postcardiotomy circulatory support

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