Five-Year results of 219 consecutive patients treated with extracorporeal membrane oxygenation for refractory postoperative cardiogenic shock

Postcardiotomy cardiogenic shock occurs in approximately 1% of patients. We prospectively evaluated the early and long-term outcome as well as predictors of survival when using temporary extracorporeal membrane oxygenation (ECMO) support. During 5 years 219 of 18,150 patients (1.2%) undergoing cardi...

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Veröffentlicht in:The Annals of thoracic surgery 2004, Vol.77 (1), p.151-157
Hauptverfasser: Doll, Nicolas, Kiaii, Bob, Borger, Michael, Bucerius, Jan, Krämer, Klaus, Schmitt, Dierk V, Walther, Thomas, Mohr, Friedrich W
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container_issue 1
container_start_page 151
container_title The Annals of thoracic surgery
container_volume 77
creator Doll, Nicolas
Kiaii, Bob
Borger, Michael
Bucerius, Jan
Krämer, Klaus
Schmitt, Dierk V
Walther, Thomas
Mohr, Friedrich W
description Postcardiotomy cardiogenic shock occurs in approximately 1% of patients. We prospectively evaluated the early and long-term outcome as well as predictors of survival when using temporary extracorporeal membrane oxygenation (ECMO) support. During 5 years 219 of 18,150 patients (1.2%) undergoing cardiac surgery (coronary artery bypass grafting, n = 119; aortic valve replacement, n = 24; coronary artery bypass grafting and aortic valve replacement, n = 21; coronary artery bypass grafting and mitral valve replacement , n = 11; other procedures, n = 44) required temporary postoperative ECMO support. The ECMO implantation was performed through the femoral vessels or through the right atrium and ascending aorta. Additional intraaortic balloon counterpulsation was employed in 144 patients to improve coronary blood flow. Mean duration of ECMO support was 2.8 ± 2.2 days. One hundred thirty-four patients (60%) were successfully weaned from ECMO. Of these, 52 patients (24%) were discharged from the hospital after 29.9 ± 24 days. The main cause of death was myocardial failure. Five-year follow-up is 96% complete; 37 patients (74%) were alive with reasonable exercise capacity. Extracorporeal membrane oxygenation is an acceptable technique for short-term treatment of refractory postoperative low cardiac output. It can save the lives of a group of very high risk patients.
doi_str_mv 10.1016/S0003-4975(03)01329-8
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We prospectively evaluated the early and long-term outcome as well as predictors of survival when using temporary extracorporeal membrane oxygenation (ECMO) support. During 5 years 219 of 18,150 patients (1.2%) undergoing cardiac surgery (coronary artery bypass grafting, n = 119; aortic valve replacement, n = 24; coronary artery bypass grafting and aortic valve replacement, n = 21; coronary artery bypass grafting and mitral valve replacement , n = 11; other procedures, n = 44) required temporary postoperative ECMO support. The ECMO implantation was performed through the femoral vessels or through the right atrium and ascending aorta. Additional intraaortic balloon counterpulsation was employed in 144 patients to improve coronary blood flow. Mean duration of ECMO support was 2.8 ± 2.2 days. One hundred thirty-four patients (60%) were successfully weaned from ECMO. Of these, 52 patients (24%) were discharged from the hospital after 29.9 ± 24 days. The main cause of death was myocardial failure. Five-year follow-up is 96% complete; 37 patients (74%) were alive with reasonable exercise capacity. Extracorporeal membrane oxygenation is an acceptable technique for short-term treatment of refractory postoperative low cardiac output. 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subjects Aged
Extracorporeal Membrane Oxygenation
Female
Humans
Male
Middle Aged
Postoperative Complications - mortality
Postoperative Complications - surgery
Prognosis
Prospective Studies
Shock, Cardiogenic - mortality
Shock, Cardiogenic - surgery
Survival Rate
Time Factors
title Five-Year results of 219 consecutive patients treated with extracorporeal membrane oxygenation for refractory postoperative cardiogenic shock
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