AIMS: We investigated survival according to the nature of heart failure (isolated left, vs isolated right, vs biventricular heart failure) in patients undergoing extracorporeal membrane oxygenation (ECMO) for refractory cardiogenic shock of different causes. METHODS AND RESULTS: This single-center study included 132 patients with acute myocardial infarction (20%), acute on chronic heart failure (14%), post cardiotomy (17%), cardiac allograft failure (8%), pulmonary embolism (16%), and acute nonischemic heart failure (25%). Ventricular function was a priori assessed by transthoracic echocardiography (isolated left (26%), isolated right (22%), or biventricular heart failure (52%)). The primary endpoint was all-cause mortality at 90 days and long-term. Predictors for adverse outcome were identified by univariate and multivariate Cox regression analysis. Median duration of ECMO support was 6 [3-9] days. Ninety-day survival was 51% (isolated LV failure 32% vs. isolated RV failure 62% vs. biventricular failure 55%, p = 0.04). The presence of isolated left ventricular failure was a predictor for 90-day mortality, irrespective of diagnosis and SAVE score. In patients who survived 90 days following ECMO implantation, long-term (4-year) survival was excellent (95%, no difference between subgroups). CONCLUSION: Isolated left ventricular failure was an independent predictor for 90-day outcome.
AIMS: We investigated survival according to the nature of heart failure (isolated left, vs isolated right, vs biventricular heart failure) in patients undergoing extracorporeal membrane oxygenation (ECMO) for refractory cardiogenic shock of different causes. METHODS AND RESULTS: This single-center study included 132 patients with acute myocardial infarction (20%), acute on chronic heart failure (14%), post cardiotomy (17%), cardiac allograft failure (8%), pulmonary embolism (16%), and acute nonischemic heart failure (25%). Ventricular function was a priori assessed by transthoracic echocardiography (isolated left (26%), isolated right (22%), or biventricular heart failure (52%)). The primary endpoint was all-cause mortality at 90 days and long-term. Predictors for adverse outcome were identified by univariate and multivariate Cox regression analysis. Median duration of ECMO support was 6 [3-9] days. Ninety-day survival was 51% (isolated LV failure 32% vs. isolated RV failure 62% vs. biventricular failure 55%, p = 0.04). The presence of isolated left ventricular failure was a predictor for 90-day mortality, irrespective of diagnosis and SAVE score. In patients who survived 90 days following ECMO implantation, long-term (4-year) survival was excellent (95%, no difference between subgroups). CONCLUSION: Isolated left ventricular failure was an independent predictor for 90-day outcome.
Authors: Alexander G Truesdell; Behnam Tehrani; Ramesh Singh; Shashank Desai; Patricia Saulino; Scott Barnett; Stephen Lavanier; Charles Murphy Journal: Interv Cardiol Date: 2018-05
Authors: Maged Makhoul; Samuel Heuts; Abdulrahman Mansouri; Fabio Silvio Taccone; Amir Obeid; Belliato Mirko; Lars Mikael Broman; Maximilian Valentin Malfertheiner; Paolo Meani; Giuseppe Maria Raffa; Thijs Delnoij; Jos Maessen; Gil Bolotin; Roberto Lorusso Journal: Artif Organs Date: 2021-07-06 Impact factor: 3.094