The Journal of Heart and Lung Transplantation
(84) - The Columbia Experience of 163 Patients with Venoarterial Extracorporeal Membranous Oxygenation for Refractory Cardiogenic Shock
Section snippets
Purpose
Refractory cardiogenic shock (RCS) is associated with significant morbidity and mortality. A surgical short-term ventricular assist device (VAD) or venoarterial membranous oxygenation (VA-ECMO) is utilized in patients who require mechanical circulatory support (MCS) at our institution. Here we report our 6-year, large volume experience with VA-ECMO for RCS.
Methods
This is a retrospective review of 163 adult patients who received VA-ECMO for RCS between March 2007 and July 2013 at our institution.
Results
Etiologies of RCS included postcardiotomy shock in 62 patients (38%), acute myocardial infarction in 43 (26.4%), graft failure post heart transplantation in 16 (9.8%), and acute decompensated heart failure in 20 (12.3%). Mean age was 57.2 ± 15.7 years. Active cardiopulmonary resuscitation (CPR) was being performed in 29.5% (n=48) and 22% (n=32) were on cardiopulmonary bypass at the time of cannulation. Mean length of support was 4.0 ± 3.5 days, with a median of 3.58 days (IQR: 1.52-5.94).
Conclusion
Outcomes of VA-ECMO for RCS appear satisfactory. Younger age and higher baseline mean arterial pressure were associated with better outcomes at 30 days.
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