Veno-Arterial Extracorporeal Membrane Oxygenation after Surgical Repair of Type A Aortic Dissection

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PC-ECMO group , Mariscalco , G , Fiore , A , Ragnarsson , S , Juvonen , T , Settembre , N & Biancari , F 2020 , ' Veno-Arterial Extracorporeal Membrane Oxygenation after Surgical Repair of Type A Aortic Dissection ' , American Journal of Cardiology , vol. 125 , no. 12 , pp. 1901-1905 . https://doi.org/10.1016/j.amjcard.2020.03.012

Title: Veno-Arterial Extracorporeal Membrane Oxygenation after Surgical Repair of Type A Aortic Dissection
Author: PC-ECMO group; Mariscalco, Giovanni; Fiore, Antonio; Ragnarsson, Sigurdur; Juvonen, Tatu; Settembre, Nicla; Biancari, Fausto
Contributor: University of Helsinki, HUS Heart and Lung Center
University of Helsinki, Department of Surgery
Date: 2020-06-15
Language: eng
Number of pages: 5
Belongs to series: American Journal of Cardiology
ISSN: 0002-9149
URI: http://hdl.handle.net/10138/328540
Abstract: Venoarterial (VA) extracorporeal membrane oxygenation (ECMO) support for postcardiotomy cardiogenic shock (PCS) in patients undergoing surgery for acute type A aortic dissection (TAAD) is controversial and the available evidence is confined to limited case series. We aimed to evaluate the impact of this salvage therapy in this patient population. Between January 2010 and March 2018, all TAAD patients receiving VA-ECMO for PCS were retrieved from the PC-ECMO registry. Hospital mortality and other secondary outcomes were compared with PCS patients undergoing surgery for other cardiac pathologies and treated with VA-ECMO. Among the 781 patients in the PC-ECMO registry, 62 (7.9%) underwent TAAD repair and required VA-ECMO support for PCS. In-hospital mortality accounted for 46 (74.2%) patients, while 23 (37.1%) were successfully weaned from VAECMO. No significant differences were observed between the TAAD and non-TAAD cohorts with reference to in-hospital mortality (74.2% vs 63.4%, p = 0.089). However, patients in the TAAD group had a higher rate of neurological events (33.9% vs 17.6%, p = 0.002), but similar rates of reoperation for bleeding/tamponade (48.4% vs 41.5%, p = 0.29), transfusion of >= 10 red blood cell units (77.4% vs 69.5%, p = 0.19), new-onset dialysis (56.7% vs 53.1%, p = 0.56), and other secondary outcomes. VA-ECMO provides a valid support for patients affected by PCS after surgery for TAAD. (C) 2020 Elsevier Inc. All rights reserved.
Subject: 3126 Surgery, anesthesiology, intensive care, radiology
Extracorporeal membrane oxygenation
ECMO, ECLS
Postcardiotomy
Cardiac surgery
Heart failure
Aortic dissection
STATEMENT
SURGERY
SUPPORT
RISK
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