University of Oulu

Fausto Biancari, Magnus Dalén, Andrea Perrotti, Antonio Fiore, Daniel Reichart, Sorosh Khodabandeh, Helmut Gulbins, Svante Zipfel, Mosab Al Shakaki, Henryk Welp, Antonella Vezzani, Tiziano Gherli, Jaakko Lommi, Tatu Juvonen, Peter Svenarud, Sidney Chocron, Jean Philippe Verhoye, Karl Bounader, Giuseppe Gatti, Marco Gabrielli, Matteo Saccocci, Eeva-Maija Kinnunen, Francesco Onorati, Giuseppe Santarpino, Khalid Alkhamees, Vito G. Ruggieri, Angelo M. Dell'Aquila, Venoarterial extracorporeal membrane oxygenation after coronary artery bypass grafting: Results of a multicenter study, International Journal of Cardiology, Volume 241, 2017, Pages 109-114, ISSN 0167-5273, https://doi.org/10.1016/j.ijcard.2017.03.120

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

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Author: Biancari, Fausto1; Dalén, Magnus2; Perrotti, Andrea3;
Organizations: 1Department of Surgery, Oulu University Hospital, Oulu, Finland
2Department of Molecular Medicine and Surgery, Department of Cardiothoracic Surgery and Anesthesiology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
3Department of Thoracic and Cardio-Vascular Surgery, University Hospital Jean Minjoz, Besançon, France
4Department of Cardiothoracic Surgery, Henri Mondor University Hospital, AP-HP, Paris-Est University, Créteil, France
5Hamburg University Heart Center, Hamburg, Germany
6Department of Cardiothoracic Surgery, University Hospital Muenster, Muenster, Germany
7Division of Cardiac Surgery, University of Parma, Parma, Italy
8Cardiac Surgery, Heart and Lung Center, Helsinki University Central Hospital, Helsinki, Finland
9Division of Cardiothoracic and Vascular Surgery, Pontchaillou University Hospital, Rennes, France
10Division of Cardiac Surgery, Ospedali Riuniti, Trieste, Italy
11Department of Cardiac Surgery, Centro Cardiologico–Fondazione Monzino IRCCS, University of Milan, Milan, Italy
12Division of Cardiovascular Surgery, Verona University Hospital, Verona, Italy
13Cardiovascular Center, Paracelsus Medical University, Nuremberg, Germany
14Saud Al-Babtain Cardiac Center, Ministry of Health, Dammam, Saudi Arabia
Format: article
Version: accepted version
Access: open
Online Access: PDF Full Text (PDF, 0.3 MB)
Persistent link: http://urn.fi/urn:nbn:fi-fe2019102134029
Language: English
Published: Elsevier, 2017
Publish Date: 2019-10-21
Description:

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). In-hospital mortality was 64.2%. Pooled in-hospital mortality was 65.9% without significant heterogeneity between the centers (I2 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.

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Series: International journal of cardiology
ISSN: 0167-5273
ISSN-E: 0167-5273
ISSN-L: 0167-5273
Volume: 241
Pages: 109 - 114
DOI: 10.1016/j.ijcard.2017.03.120
OADOI: https://oadoi.org/10.1016/j.ijcard.2017.03.120
Type of Publication: A1 Journal article – refereed
Field of Science: 3126 Surgery, anesthesiology, intensive care, radiology
Subjects:
Copyright information: © 2017 Elsevier B.V. All rights reserved. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/.
  https://creativecommons.org/licenses/by-nc-nd/4.0/