Venoarterial extracorporeal membrane oxygenation after coronary artery bypass grafting : Results of a multicenter study

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http://hdl.handle.net/10138/297825

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Biancari , F , Dalen , M , Perrotti , A , Fiore , A , Reichart , D , Khodabandeh , S , Gulbins , H , Zipfel , S , Al Shakaki , M , Welp , H , Vezzani , A , Gherli , T , Lommi , J , Juvonen , T , Svenarud , P , Chocron , S , Verhoye , J-P , Bounader , K , Gatti , G , Gabrielli , M , Saccocci , M , Kinnunen , E-M , Onorati , F , Santarpino , G , Alkhamees , K , Ruggieri , V G & Dell'Aquila , A M 2017 , ' Venoarterial extracorporeal membrane oxygenation after coronary artery bypass grafting : Results of a multicenter study ' , International Journal of Cardiology , vol. 241 , pp. 109-114 . https://doi.org/10.1016/j.ijcard.2017.03.120

Title: Venoarterial extracorporeal membrane oxygenation after coronary artery bypass grafting : Results of a multicenter study
Author: Biancari, Fausto; Dalen, Magnus; Perrotti, Andrea; Fiore, Antonio; Reichart, Daniel; Khodabandeh, Sorosh; Gulbins, Helmut; Zipfel, Svante; Al Shakaki, Mosab; Welp, Henryk; Vezzani, Antonella; Gherli, Tiziano; Lommi, Jaakko; Juvonen, Tatu; Svenarud, Peter; Chocron, Sidney; Verhoye, Jean-Philippe; Bounader, Karl; Gatti, Giuseppe; Gabrielli, Marco; Saccocci, Matteo; Kinnunen, Eeva-Maija; Onorati, Francesco; Santarpino, Giuseppe; Alkhamees, Khalid; Ruggieri, Vito G.; Dell'Aquila, Angelo M.
Other contributor: University of Helsinki, University of Helsinki



Date: 2017-08-15
Language: eng
Number of pages: 6
Belongs to series: International Journal of Cardiology
ISSN: 0167-5273
DOI: https://doi.org/10.1016/j.ijcard.2017.03.120
URI: http://hdl.handle.net/10138/297825
Abstract: Background: The evidence of the benefits of using venoarterial extracorporeal membrane oxygenation (VA-ECMO) after coronary artery bypass grafting (CABG) is scarce. Methods: We analyzed the outcomes of patients who received VA-ECMO therapy due to cardiac or respiratory failure after isolated CABG in 12 centers between 2005 and 2016. Patients treated preoperatively with ECMO were excluded from this study. Results: VA-ECMO was employed in 148 patients after CABG for median of 5.0 days (mean, 6.4, SD 5.6 days). Inhospital mortality was 64.2%. Pooled in-hospital mortality was 65.9% without significant heterogeneity between the centers (I-2 8.6%). The proportion of VA-ECMO in each center did not affect in-hospital mortality (p = 0.861). No patients underwent heart transplantation and six patients received a left ventricular assist device. Logistic regression showed that creatinine clearance (p = 0.004, OR 0.98, 95% CI 0.97-0.99), pulmonary disease (p = 0.018, OR 4.42, 95% CI 1.29-15.15) and pre-VA-ECMO blood lactate (p = 0.015, OR 1.10, 95% CI 1.02-1.18) were independent baseline predictors of in-hospital mortality. One-, 2-, and 3-year survival was 31.0%, 27.9%, and 26.1%, respectively. Conclusions: One third of patients with need for VA-ECMO after CABG survive to discharge. In view of the burden of resources associated with VA-ECMO treatment and the limited number of patients surviving to discharge, further studies are needed to identify patients who may benefit the most from this treatment. (C) 2017 Elsevier B.V. All rights reserved.
Subject: Coronary artery bypass
CABG
Post-cardiotomy
Heart failure
ECMO
ECLS
Extracorporeal membrane oxygenation
Extracorporeal life support
POSTCARDIOTOMY CARDIOGENIC-SHOCK
ADULT PATIENTS
SUPPORT
THERAPY
MYOCARDIUM
EXPERIENCE
OUTCOMES
SURGERY
FLOW
3121 General medicine, internal medicine and other clinical medicine
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