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Percutaneous Venoarterial Extracorporeal Membrane Oxygenation for Refractory Cardiogenic Shock Is Associated with Improved Short- and Long-Term Survival

Authors :
Hryniewicz, Katarzyna
Sandoval, Yader
Samara, Michael
Bennett, Mosi
Cabuay, Barry
Chavez, Ivan J.
Seatter, Susan
Eckman, Peter
Zimbwa, Peter
Dunn, Aaron
Sun, Benjamin
Source :
ASAIO Journal: A Peer-Reviewed Journal of the American Society for Artificial Internal Organs; July-August 2016, Vol. 62 Issue: 4 p397-402, 6p
Publication Year :
2016

Abstract

Mortality due to refractory cardiogenic shock (RCS) exceeds 50%. Venoarterial extracorporeal membrane oxygenation (VA-ECMO) has become an accepted therapy for RCS. The aim of our study was to evaluate outcomes of patients with RCS treated with percutaneous VA-ECMO (pVA-ECMO). Retrospective review of patients supported with VA-ECMO at our institution in 2012–2013. Clinical characteristics, bleeding, vascular complications, and outcomes including survival were assessed. A total of 37 patients were supported with VA-ECMO for RCS. The majority of VA-ECMO (76%) was placed in the catheterization laboratory. Nearly half (49%) of the patients presented with acute myocardial infarction. Seven patients (19%) underwent insertion of pVA-ECMO in the setting of cardiopulmonary resuscitation with mechanical chest compression device. Median duration of support was 5 days. Index hospitalization, 30-day, and 1-year survival were 65%, 65%, and 57%, respectively. Survival rate for discharged patients was 87.5% with a median follow-up of 450 days. Refractory cardiogenic shock supported with pVA-ECMO is associated with an improved survival in patients with a traditionally poor prognosis.

Details

Language :
English
ISSN :
10582916 and 1538943X
Volume :
62
Issue :
4
Database :
Supplemental Index
Journal :
ASAIO Journal: A Peer-Reviewed Journal of the American Society for Artificial Internal Organs
Publication Type :
Periodical
Accession number :
ejs48385748
Full Text :
https://doi.org/10.1097/MAT.0000000000000378