Universität zu Köln

Djordjevic, Ilija ORCID: 0000-0002-5810-8626, Eghbalzadeh, Kaveh, Sabashnikov, Anton, Deppe, Antje C., Kuhn, Elmar W., Seo, Joon, Weber, Carolyn, Merkle, Julia, Adler, Christoph, Rahmanian, Parwis B. ORCID: 0000-0002-3978-9251, Liakopoulos, Oliver J., Mader, Navid, Kuhn-Regnier, Ferdinand, Zeriouh, Mohamed and Wahlers, Thorsten (2020). Single center experience with patients on veno arterial ECMO due to postcardiotomy right ventricular failure. J. Card. Surg., 35 (1). S. 83 - 89. HOBOKEN: WILEY. ISSN 1540-8191

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Abstract

Objectives Right ventricular (RV) failure is associated with poor outcome and increased mortality in cardiac surgery. Aim of our study was to analyze the outcome of veno arterial extracorporeal membrane oxygenation (va ECMO) therapy in patients with isolated RV failure in postcardiotomy cardiogenic shock (PCS) and to evaluate risk factors associated with 30-day-mortality. Methods Between August 2006 until August 2016, 64 consecutive patients with va ECMO therapy due to fulminant RV failure in PCS were identified and included in this retrospective observation. Further, outcome data and a comparison of va ECMO survivors and nonsurvivors was conducted. Results The mean age of the patient cohort was 63 +/- 14 years. Patients were treated with va ECMO for 79 +/- 61 hours. Twenty-eight patients (44%) were successfully weaned off ECMO support. Overall 30-day-mortality was 88% (56/64). Hemoglobin concentration before ECMO implantation, maximum rise of muscle-brain type creatine kinase during ECMO therapy, as well as lactic acid concentration 24 hours after initiation of va ECMO therapy were predictive for 30-day mortality. Conclusion ECMO therapy in RV failure due to PCS is shown to be associated with an excessive mortality. Regarding our data, va ECMO might only be an appropriate short-term mechanical assist device separating patients form cardiopulmonary bypass with an acceptable weaning rate. Particularly, in case of failed hemodynamic recovery of the right heart on va ECMO, direct RV bypass systems might function as a bailout option. Additionally, cardiac enzymes and lactic acid might provide valuable information in meeting therapy-related decisions.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Djordjevic, Ilija UNSPECIFIED orcid.org/0000-0002-5810-8626 UNSPECIFIED Eghbalzadeh, Kaveh UNSPECIFIED UNSPECIFIED UNSPECIFIED Sabashnikov, Anton UNSPECIFIED UNSPECIFIED UNSPECIFIED Deppe, Antje C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuhn, Elmar W. UNSPECIFIED UNSPECIFIED UNSPECIFIED Seo, Joon UNSPECIFIED UNSPECIFIED UNSPECIFIED Weber, Carolyn UNSPECIFIED UNSPECIFIED UNSPECIFIED Merkle, Julia UNSPECIFIED UNSPECIFIED UNSPECIFIED Adler, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Rahmanian, Parwis B. UNSPECIFIED orcid.org/0000-0002-3978-9251 UNSPECIFIED Liakopoulos, Oliver J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Mader, Navid UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuhn-Regnier, Ferdinand UNSPECIFIED UNSPECIFIED UNSPECIFIED Zeriouh, Mohamed UNSPECIFIED UNSPECIFIED UNSPECIFIED Wahlers, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-128148
DOI:	10.1111/jocs.14332
Journal or Publication Title:	J. Card. Surg.
Volume:	35
Number:	1
Page Range:	S. 83 - 89
Date:	2020
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1540-8191
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language EXTRACORPOREAL MEMBRANE-OXYGENATION; REFRACTORY CARDIOGENIC-SHOCK; CARDIAC-SURGERY; CIRCULATORY SUPPORT; MECHANICAL SUPPORT; ASSIST DEVICES; OUTCOMES; BYPASS; DYSFUNCTION; STRATEGIES Multiple languages Cardiac & Cardiovascular Systems; Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/12814