Journal article
Concomitant use of extracorporeal membrane oxygenation and percutaneous microaxial assist device support for cardiogenic shock
JTCVS open, v 17, pp 152-161
01 Feb 2024
PMID: 38420544
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Venoarterial extracorporeal membrane oxygenation (VA-ECMO) with concomitant percutaneous microaxial left ventricular assist device support is an emerging treatment modality for cardiogenic shock (CS). Survival outcomes by CS etiology with this support strategy have not been well described.
This study was a retrospective, single-center analysis of patients with CS due to acute myocardial infarction (AMI-CS) or decompensated heart failure (ADHF-CS) supported with VA-ECMO with concomitant percutaneous microaxial left ventricular assist device support from December 2020 to January 2023.
A total of 44 patients were included (AMI-CS, n = 20, and ADHF-CS, n = 24). Patients with AMI-CS and ADHF-CS had similar survival at 90 days postdischarge (P = .267) with similar destinations after support (P = .220). Patients with AMI-CS initially supported with VA-ECMO were less likely to survive 90 days postdischarge (P = .038) when compared with other cohorts. Limb ischemia and acute kidney injury occurred more frequently in patients presenting with AMI-CS (P =.013; P = .030). Subanalysis of ADHF-CS patients into acute-on-chronic decompensated HF and de novo HF demonstrated no difference in survival or destination.
VA-ECMO with concomitant percutaneous microaxial left ventricular assist device support can be used to successfully manage patients with CS. There is no difference in survival or destination for AMI-CS and ADHF-CS with this support strategy. AMI-CS patients with initial VA-ECMO support have increased mortality in comparison to other cohorts. Future multicenter studies are required to fully analyze the differences between AMI-CS and ADHF-CS with this support strategy.
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Details
- Title
- Concomitant use of extracorporeal membrane oxygenation and percutaneous microaxial assist device support for cardiogenic shock
- Creators
- Shan P. Modi - University of Pittsburgh Medical CenterYeahwa Hong - University of Pittsburgh Medical CenterMcKenzie M. Sicke - University of Pittsburgh Medical CenterNicholas R. Hess - University of Pittsburgh Medical CenterWyatt J. Klass - University of Pittsburgh Medical CenterLuke A. Ziegler - University of Pittsburgh Medical CenterRyan M. Rivosecchi - University of Pittsburgh Medical CenterGavin W. Hickey - University of Pittsburgh Medical CenterDavid J. Kaczorowski - University of Pittsburgh Medical CenterRaj Ramanan - University of Pittsburgh Medical Center
- Publication Details
- JTCVS open, v 17, pp 152-161
- Publisher
- Elsevier
- Number of pages
- 10
- Grant note
- T32HL160526 / National Heart, Lung, and Blood Institute (https://doi.org/10.13039/100000050) Thoracic Surgery Foundation (https://doi.org/10.13039/100010261)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Surgery; Emergency Medicine
- Web of Science ID
- WOS:001314444900001
- Scopus ID
- 2-s2.0-85182366553
- Other Identifier
- 991022008086404721
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InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Cardiac & Cardiovascular Systems
- Respiratory System
- Surgery