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Background: Obesity is known to impact outcomes of patients undergoing in-patient care in general. The association between veno-arterial extracorporeal membrane oxygenation (VA ECMO) and obesity-related outcomes remains unclear. Therefore, we sought to investigate weight-associated differences of patients treated with VA ECMO., Method: A retrospective study was performed for patients who required veno-arterial (VA) ECMO support at our tertiary ECMO centre between 1 March 2006 and 28 February 2017. Patients were categorised according to Body-Mass-Index (BMI) associated values in six groups (underweight, normal range, overweight, obese class I-III). Further, patients were divided into non-obese (18.5-29-9 kg/m 2 ) and obese (≥30 kg/m 2 ) groups and analysed concerning baseline, ECMO-related, and general outcome parameters., Results: A total of 244 patients required VA ECMO support during the study period. Subgroup-analysis of BMI-category associated impact on in-hospital mortality showed the highest incidence of mortality in obese class II patients (93%) with a significant difference between overweighted patients. Non-obesity was present in 179, whereas 59 patients suffered obesity. Obese patients were significantly older (p=0.022) and suffered significantly more diabetes (21% non-obese vs 48% obese; p<0.001). Indication for support, laboratory parameters prior to ECMO, and ECMO-related outcomes did not differ between the groups. Obese patients showed a trend towards higher in-hospital mortality (70% non-obese vs 81% obese; p=0.085)., Conclusions: Obesity is associated with comparable outcomes to non-obese patients, showing a tendency of higher mortality. Obese class II patients presented the highest risk of death compared to all BMI categories., (Copyright © 2022 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.)

Background: Prognosis of patients with end-stage heart failure is known to be impacted by the aetiology of heart failure (HF). Ischaemic cardiomyopathy (ICM) and dilated cardiomyopathy (DCM) are the most frequent pathologies necessitating ventricular assist device (VAD) support in these patients. However, the specific impact of ICM and DCM in clinical outcomes after VAD implantation remains unclear. Therefore, this study aimed to analyse clinical differences in ICM and DCM patients after LVAD surgery from the current institution., Methods: All consecutive patients from the LVAD centre were included in this retrospective study. To analyse specific differences in in-hospital outcomes, patients were divided into two groups: ICM and DCM. Long-term follow-up was calculated by Kaplan-Meier estimation of survival., Results: Between January 2010 and July 2020, 60 consecutive patients underwent LVAD implantation at the institution: 36 patients (60%) were supported due to end-stage ICM and 24 patients (40%) in regard of therapy-refractory DCM. Baseline characteristics showed no between-group differences. The ICM patients showed a clear trend to higher amount of additional cardiac procedures during VAD surgery (36% ICM vs 12% DCM; p=0.052). In-hospital mortality was comparable between ICM and DCM patients (36% ICM vs 21% DCM; p=0.206). A trend towards higher frequency of pump thrombosis was seen in DCM patients (p=0.080). Long-term survival was comparable between the groups., Conclusion: The aetiology of heart failure did not impact short-term or long-term clinical outcomes after VAD surgery. Multicentre registry data are necessary to substantiate these findings., (Copyright © 2021 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.)

Objectives: Simultaneous mechanical circulatory support (MCS) with intra-aortic balloon pump (IABP) to extracorporeal membrane oxygenation (ECMO) is common in postcardiotomy cardiogenic shock (PCS). This study aimed to analyse the effect of concomitant ECMO and IABP therapy on the short-term outcomes of patients with PCS., Methods: Between March 2006 and March 2017, 172 consecutive patients with central (c) or peripheral (p) veno-arterial ECMO therapy due to PCS were identified at the current institution and included in this retrospective analysis. Patients were divided into ECMO+IABP and ECMO alone groups. Further, the impact of ECMO flow direction was analysed for the groups., Results: A total of 129 patients received ECMO+IABP support and 43 patients were treated with ECMO alone. Median ECMO duration did not differ between the groups (68 [34; 95] hours ECMO+IABP vs 44 [20; 103] hours ECMO; p=0.151). However, a trend toward a higher weaning rate was evident in ECMO+IABP patients (75 [58%] ECMO+IABP vs 18 [42%] ECMO; p=0.078). Concomitant IABP support with either cECMO (73% [n=24] cECMO+IABP vs 50% [n=11] ECMO; p=0.098) or pECMO (57% [n=55] ECMO+IABP vs 33% [n=7] ECMO; p=0.056) was also associated with a trend toward a higher weaning rate off ECMO. In-hospital mortality did not differ between the groups., Conclusion: This analysis found that, independent of ECMO type, additional IABP support might increase ECMO weaning; however, it did not influence survival in PCS patients. Larger studies are necessary to further analyse the impact of this concomitant MSC therapy on clinical outcomes., (Copyright © 2021 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.)