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Outcomes of left ventricular unloading with a transseptal cannula during extracorporeal membrane oxygenation in adults.
- Source :
- Artificial Organs; Apr2021, Vol. 45 Issue 4, p390-398, 9p
- Publication Year :
- 2021
-
Abstract
- We evaluated the benefit of left ventricular (LV) unloading using a percutaneous transseptal left atrial (LA) drain catheter via femoral vein incorporated into the ECMO venous circuit. This single‐center retrospective observational study analyzed clinical outcomes of the LA venting group (N = 62) who underwent percutaneous transseptal LA drain placement comparing with the conventionally treated control group (N = 62) with an arterial pulse pressure below 10 mm Hg for at least 24 hours from December 2012 to August 2018. The ECMO weaning rate (61.3% vs. 38.7%, P =.012) and cardiac transplantation rate (29.0% vs. 11.3%, P =.014) were higher in the LA venting group than in the control group. Inhospital mortality was not significantly different (56.5% vs. 69.4%, P =.191). Pulmonary congestion mostly improved after LA decompression (61.3%, P =.003). A serum lactate level at 24 hours after LA venting of more than 2.2 mmol/L was associated with poor outcomes. LA venting via transseptal cannula reduced pulmonary venous congestion and achieved higher rates of successful ECMO weaning and cardiac transplantation. Placement of a transseptal venous drain cannula should be considered in patients with uncontrolled pulmonary edema secondary to severe LV loading undergoing VA‐ECMO. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 0160564X
- Volume :
- 45
- Issue :
- 4
- Database :
- Complementary Index
- Journal :
- Artificial Organs
- Publication Type :
- Academic Journal
- Accession number :
- 149399444
- Full Text :
- https://doi.org/10.1111/aor.13838