Refractory cardiogenic shock due to extensive anterior STEMI with covered left ventricular free wall rupture treated with awake VA-ECMO and LVAD as a double bridge to heart transplantation - collaboration of three cardiac centres

Kacer, J; Lindovská, Michaela; Surovčík, Roman; Netuka, Ivan; Mlejnský, František; Grus, Tomáš; Bělohlávek, Jan

doi:10.5507/bp.2015.044

Cited by 9 publications

(5 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 10 Likewise, the strategy has been attempted in patients undergoing high-risk percutaneous coronary intervention or suffering from refractory cardiogenic shock, but no studies involving a population bridged to transplantation were found. 28 29 30 Therefore, we investigated whether the use of an early extubation ECMO strategy is beneficial in patients who received VA-ECMO as a bridge to HT and found that early extubation VA-ECMO was associated with reductions in the rates of delirium and infection. A subgroup analysis with successfully transplanted patients also showed the existence of less postoperative days on mechanical ventilation and reduced ICU stay length in the early extubation group, presumably leading to reductions in medical costs and complications related to prolonged hospitalization.…”

Section: Discussionmentioning

confidence: 99%

Clinical Outcomes of Early Extubation Strategy in Patients Undergoing Extracorporeal Membrane Oxygenation as a Bridge to Heart Transplantation

et al. 2020

View full text Add to dashboard Cite

Background Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) might be considered a bridge therapy in patients who are expected to have short waiting times for heart transplantation. We investigated the clinical outcomes of patients who underwent VA-ECMO as a bridge to heart transplantation and whether the deployment of an early extubation ECMO strategy is beneficial. Methods Between November 2006 and December 2018, we studied 102 patients who received VA-ECMO as a bridge to heart transplantation. We classified these patients into an early extubation ECMO group (n = 24) and a deferred extubation ECMO group (n = 78) based on the length of the intubated period on VA-ECMO (≤ 48 hours or > 48 hours). The primary outcome was in-hospital mortality. Results The median duration of early extubation VA-ECMO was 10.0 (4.3–17.3) days. The most common cause for patients to be put on ECMO was dilated cardiomyopathy (65.7%) followed by ischemic cardiomyopathy (11.8%). In-hospital mortality rates for the deferred extubation and early extubation groups, respectively, were 24.4% and 8.3% ( P = 0.147). During the study period, in the deferred extubation group, 60 (76.9%) underwent transplantation, while 22 (91.7%) underwent transplantation in the early extubation group. Delirium occurred in 83.3% and 33.3% of patients from the deferred extubation and early extubation groups ( P < 0.001) and microbiologically confirmed infection was identified in 64.1% and 41.7% of patients from the two groups ( P = 0.051), respectively. Conclusion VA-ECMO as a bridge therapy seems to be feasible for deployment in patients with a short waiting time for heart transplantation. Deployment of the early extubation ECMO strategy was associated with reductions in delirium and infection in this population.

show abstract

Section: Discussionmentioning

confidence: 99%

Clinical Outcomes of Early Extubation Strategy in Patients Undergoing Extracorporeal Membrane Oxygenation as a Bridge to Heart Transplantation

et al. 2020

View full text Add to dashboard Cite

show abstract

“…The literature on LVAD implantation after contained free wall rupture is limited to few case reports. 1 6 7 Two reasons precluded implantation of an extracorporeal LVAD with a left atrial inflow cannula in our patient: the contained rupture with a potential for late bleeding and a good quality of life postoperatively.…”

Section: Discussionmentioning

confidence: 98%

“…Implantation after contained rupture of the free wall of the left ventricle (pseudoaneurysm) is challenging and information scarce. 1 …”

Section: Introductionmentioning

confidence: 99%

Left Ventricular Assist Device Implantation in a Patient with Ventricular Pseudoaneurysm

Radakovic¹,

Penov²,

Güder

et al. 2022

Thorac Cardiovasc Surg Rep

View full text Add to dashboard Cite

Background Left ventricular assist device (LVAD) implantation after contained LV rupture (pseudoaneurysm) represents a difficult surgical problem. Case Description We describe the surgical approach for such a patient. The sewing ring was implanted utilizing a Dacron patch for reconstruction of the free wall, fibrotic LV wall remnants, and a Teflon strip giving additional support for cannula position and hemostasis. The patient had an uneventful recovery and is well 19 months after the procedure. Conclusion LV pseudoaneurysm is not a contraindication for permanent LVAD implantation.

show abstract

“…Commonly, intra-aortic counterpulsation is used to reduce left ventricular afterload and left-to-right shunting in ischemic VSD to stabilize patients for surgical repair. There are a few cases reported in which patients with CS after MI received veno-arterial extracorporeal membrane oxygenation (vaEC-MO) as bridging prior to surgery with good results (6)(7)(8)(9). Recently, vaECMO has been increasingly used in order to improve hemodynamic instable patients (10).…”

Section: Introductionmentioning

confidence: 99%

ECMO and Cytokine Removal for Bridging to Surgery in a Patient with Ischemic Ventricular Septal Defect – a Case Report

et al. 2017

View full text Add to dashboard Cite

Even in the modern era of percutaneous coronary intervention, postinfarction ventricular septal defect (VSD) remains a serious and often lethal complication. Whether or not immediate surgical repair or delaying surgery a few days aided by intra-aortic counterpulsation provides the optimal strategy remains a matter of debate. An interdisciplinary approach of intensivists and cardiac surgeons in this setting is mandatory. We report the use of veno-arterial extracorporeal membrane oxygenation and extracorporeal blood purification therapy (CytoSorb®) as bridging to surgical closure in a patient with an ischemic VSD leading to protracted cardiogenic shock after posterior myocardial infarction.

show abstract

Refractory cardiogenic shock due to extensive anterior STEMI with covered left ventricular free wall rupture treated with awake VA-ECMO and LVAD as a double bridge to heart transplantation - collaboration of three cardiac centres

Cited by 9 publications

References 18 publications

Clinical Outcomes of Early Extubation Strategy in Patients Undergoing Extracorporeal Membrane Oxygenation as a Bridge to Heart Transplantation

Clinical Outcomes of Early Extubation Strategy in Patients Undergoing Extracorporeal Membrane Oxygenation as a Bridge to Heart Transplantation

Left Ventricular Assist Device Implantation in a Patient with Ventricular Pseudoaneurysm

ECMO and Cytokine Removal for Bridging to Surgery in a Patient with Ischemic Ventricular Septal Defect – a Case Report

Contact Info

Product

Resources

About