OBJECTIVES: To investigate the therapeutic impact of combining extracorporeal membrane oxygenation (ECMO) and early coronary revascularization on acute myocardial infarction (AMI)-induced cardiopulmonary collapse. MATERIALS AND METHODS: This retrospective study included 35 consecutive patients rescued by ECMO for AMI-induced cardiopulmonary collapse in a single institution between June 2003 and December 2011. Coronary revascularization was performed soon after ECMO initiation. Percutaneous coronary intervention (PCI) was the primary revascularization strategy. Coronary artery bypass grafting (CABG) was performed if an unsuitable anatomy or unsatisfactory result of PCI. Comparisons were performed in groups with different revascularization strategies and outcomes. RESULTS: Among the 35 patients, 16 underwent CABG and 1 was bridged to transplant after CABG. Compared to patients receiving PCI only, the CABG group showed similar results in ECMO weaning (58% vs. 69%, p=0.51), hospital discharge (32% vs. 50%, p=0.27), and left ventricular ejection fraction before discharge (45% vs. 49%, p=0.92). Regardless of revascularization strategies, this protocol achieved an ECMO-weaning rate of 63% and a hospital discharge rate of 40%. Dialysis-dependent acute renal failure (OR 5.4, 95% CI: 1.1-27.5) and profound anoxic encephalopathy (OR 5.4, 95% CI: 1.1-27.5) predicted non-weaning of ECMO. Age>60 years (OR 7.3, 95% CI: 1.1-51.0) and profound anoxic encephalopathy (OR 24.6, 95% CI: 2.3-263.0) predicted in-hospital mortality. The major cardiovascular adverse effect (MACE)-free survival was 77% in the first year after discharge. CONCLUSION: Early revascularization on ECMO is practical to preserve myocardial viability and bridge patients collapsing with AMI to recovery.
OBJECTIVES: To investigate the therapeutic impact of combining extracorporeal membrane oxygenation (ECMO) and early coronary revascularization on acute myocardial infarction (AMI)-induced cardiopulmonary collapse. MATERIALS AND METHODS: This retrospective study included 35 consecutive patients rescued by ECMO for AMI-induced cardiopulmonary collapse in a single institution between June 2003 and December 2011. Coronary revascularization was performed soon after ECMO initiation. Percutaneous coronary intervention (PCI) was the primary revascularization strategy. Coronary artery bypass grafting (CABG) was performed if an unsuitable anatomy or unsatisfactory result of PCI. Comparisons were performed in groups with different revascularization strategies and outcomes. RESULTS: Among the 35 patients, 16 underwent CABG and 1 was bridged to transplant after CABG. Compared to patients receiving PCI only, the CABG group showed similar results in ECMO weaning (58% vs. 69%, p=0.51), hospital discharge (32% vs. 50%, p=0.27), and left ventricular ejection fraction before discharge (45% vs. 49%, p=0.92). Regardless of revascularization strategies, this protocol achieved an ECMO-weaning rate of 63% and a hospital discharge rate of 40%. Dialysis-dependent acute renal failure (OR 5.4, 95% CI: 1.1-27.5) and profound anoxic encephalopathy (OR 5.4, 95% CI: 1.1-27.5) predicted non-weaning of ECMO. Age>60 years (OR 7.3, 95% CI: 1.1-51.0) and profound anoxic encephalopathy (OR 24.6, 95% CI: 2.3-263.0) predicted in-hospital mortality. The major cardiovascular adverse effect (MACE)-free survival was 77% in the first year after discharge. CONCLUSION: Early revascularization on ECMO is practical to preserve myocardial viability and bridge patients collapsing with AMI to recovery.
Authors: Philipp Pichler; Herwig Antretter; Martin Dünser; Stephan Eschertzhuber; Roman Gottardi; Gottfried Heinz; Gerhard Pölzl; Ingrid Pretsch; Angelika Rajek; Andrä Wasler; Daniel Zimpfer; Alexander Geppert Journal: Wien Klin Wochenschr Date: 2015-03-28 Impact factor: 1.704
Authors: Taek Kyu Park; Jeong Hoon Yang; Seung-Hyuk Choi; Young Bin Song; Joo-Yong Hahn; Jin-Ho Choi; Kiick Sung; Young Tak Lee; Hyeon-Cheol Gwon; Sang Hoon Lee Journal: Yonsei Med J Date: 2014-07 Impact factor: 2.759
Authors: Adamantios Tsangaris; Tamas Alexy; Rajat Kalra; Marinos Kosmopoulos; Andrea Elliott; Jason A Bartos; Demetris Yannopoulos Journal: Front Cardiovasc Med Date: 2021-07-07
Authors: Kun Il Kim; Hee Sung Lee; Hyoung Soo Kim; Sang Ook Ha; Won Yong Lee; Sang Jun Park; Sun Hee Lee; Tae Hun Lee; Jeong Yeol Seo; Hyun Hee Choi; Kyu Tae Park; Sang Jin Han; Kyung Soon Hong; Sung Mi Hwang; Jae Jun Lee Journal: Scand J Trauma Resusc Emerg Med Date: 2015-08-17 Impact factor: 2.953
Authors: Jason A Bartos; Sebastian Voicu; Timothy R Matsuura; Adamantios Tsangaris; Georgios Sideris; Brett A Oestreich; Stephen A George; Matthew Olson; Kadambari Chandra Shekar; Jennifer N Rees; Kathleen Carlson; Pierre Sebastian; Scott McKnite; Ganesh Raveendran; Tom P Aufderheide; Demetris Yannopoulos Journal: JACC Basic Transl Sci Date: 2017-06-21