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Prophylactic veno-arterial extracorporeal membrane oxygenation in patients undergoing high-risk percutaneous coronary intervention.
van den Brink, F S; Meijers, T A; Hofma, S H; van Boven, A J; Nap, A; Vonk, A; Symersky, P; Sjauw, K D; Knaapen, P.
Afiliación
  • van den Brink FS; Department of Cardiology, Medisch Centrum Leeuwarden, Leeuwarden, The Netherlands. floris.s.van.den.brink@gmail.com.
  • Meijers TA; Department of Cardiology, Location Vrije Universiteit Medisch Centrum, Amsterdam Universitair Medisch Centrum, Amsterdam, The Netherlands.
  • Hofma SH; Department of Cardiology, Medisch Centrum Leeuwarden, Leeuwarden, The Netherlands.
  • van Boven AJ; Department of Cardiology, Medisch Centrum Leeuwarden, Leeuwarden, The Netherlands.
  • Nap A; Department of Cardiology, Location Vrije Universiteit Medisch Centrum, Amsterdam Universitair Medisch Centrum, Amsterdam, The Netherlands.
  • Vonk A; Department of Cardiology, Location Vrije Universiteit Medisch Centrum, Amsterdam Universitair Medisch Centrum, Amsterdam, The Netherlands.
  • Symersky P; Department of Cardio-Thoracic Surgery, Location Vrije Universiteit Medisch Centrum, Amsterdam Universitair Medisch Centrum, Amsterdam, The Netherlands.
  • Sjauw KD; Department of Cardiology, Medisch Centrum Leeuwarden, Leeuwarden, The Netherlands.
  • Knaapen P; Department of Cardiology, Location Vrije Universiteit Medisch Centrum, Amsterdam Universitair Medisch Centrum, Amsterdam, The Netherlands.
Neth Heart J ; 28(3): 139-144, 2020 Mar.
Article en En | MEDLINE | ID: mdl-31782108
PURPOSE: Complex high-risk percutaneous coronary intervention (PCI) is challenging and frequently accompanied by haemodynamic instability. Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) can provide cardiopulmonary support in high-risk PCI. However, the outcome is unclear. METHODS: A two-centre, retrospective study was performed of all patients undergoing high-risk PCI and receiving VA-ECMO for cardiopulmonary support. RESULTS: A total of 14 patients (92% male, median age 69 (53-83) years), of whom 50% had previous coronary artery disease in the form of a coronary artery bypass graft (36%) and a PCI (14%) underwent high-risk PCI and received VA-ECMO support. The main target lesion was a left main coronary artery in 78%, a left anterior descending artery in 14%, a right coronary artery in 7%, and 71% underwent multi-vessel PCI in addition to main target vessel PCI. The median SYNTAX score was 27.2 (8-42.5) and in 64% (9/14) there was a chronic total occlusion. Left ventricular function was mildly impaired in 7% (1/14), moderately impaired in 14% (2/14) and severely impaired in 64% (9/14). Cannulation was femoral-femoral in all patients. Median ECMO run was 2.57 h (1-4). Survival was 93% (13/14). One patient died during hospitalisation due to refractory cardiac failure. All other patients survived to discharge. Complications occurred in 14% (2/14), with one patient developing a transient ischaemic attack post-ECMO and one patient developing a thrombus in the femoral vein used for ECMO cannulation. CONCLUSION: VA-ECMO in high-risk PCI is feasible with a good outcome. It can be successfully used for cardiopulmonary support in selected patients.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Etiology_studies / Observational_studies / Risk_factors_studies Idioma: En Revista: Neth Heart J Año: 2020 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Países Bajos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Etiology_studies / Observational_studies / Risk_factors_studies Idioma: En Revista: Neth Heart J Año: 2020 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Países Bajos