A rationale for early extracorporeal membrane oxygenation in patients with postinfarction ventricular septal rupture complicated by cardiogenic shock

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11110%2F17%3A10360590" target="_blank" >RIV/00216208:11110/17:10360590 - isvavai.cz</a>

Alternative codes found

RIV/00216208:11130/17:10360590 RIV/00064203:_____/17:10360590 RIV/00064165:_____/17:10360590

Result on the web

<a href="http://onlinelibrary.wiley.com/doi/10.1002/ejhf.852/abstract" target="_blank" >http://onlinelibrary.wiley.com/doi/10.1002/ejhf.852/abstract</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1002/ejhf.852" target="_blank" >10.1002/ejhf.852</a>

Result language

angličtina

Original language name

A rationale for early extracorporeal membrane oxygenation in patients with postinfarction ventricular septal rupture complicated by cardiogenic shock

Original language description

Aims Ventricular septal rupture (VSR) became a rare mechanical complication of myocardial infarction in the era of percutaneous coronary interventions but is associated with extreme mortality in patients who present with cardiogenic shock (CS). Promising outcomes have been reported with the use of circulatory support allowing haemodynamic stabilization, followed by delayed repair. Therefore, we analysed our experience with an early use of Veno-Arterial Extracorporeal Membrane Oxygenation (V-A ECMO) for postinfarction VSR. Methods and results We conducted a retrospective search of institutional database for patients presenting with postinfarction VSR from January 2007 to June 2016. Data from 31 consecutive patients (mean age 69.5 +/- 9.1 years) who were admitted to hospital were analysed. Seven out of 31 patients with VSR who were in refractory CS received V-A ECMO support preoperatively. ECMO improved end-organ perfusion with decreased lactate levels 24 hours after implantation (7.9 mmol/L vs. 1.6 mmol/L, p = 0.01), normalized arterial pH (7.25 vs. 7.40, p &lt; 0.04), improved mean arterial pressure (64 mmHg vs. 83 mmHg, p &lt; 0.01) and lowered heart rate (115/min vs. 68/min, p &lt; 0.01). Mean duration of ECMO support was 12 days, 5 out of 7 patients underwent surgical repair, 4 were weaned from ECMO, 3 survived 30 days and 2 survived more than 1 year. The most frequent complication (5 patients) and the cause of death (3 patients) was bleeding. Conclusions Our experience suggests that early V-A ECMO in patients with VSR and refractory CS might prevent irreversible multiorgan failure by improved end-organ perfusion. Bleeding complications remain an important limitation of this approach.

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

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OECD FORD branch

30201 - Cardiac and Cardiovascular systems

Project

—

Continuities

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Publication year

2017

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

European Journal of Heart Failure

ISSN

1388-9842

e-ISSN

—

Volume of the periodical

19

Issue of the periodical within the volume

Supplement 2

Country of publishing house

NL - THE KINGDOM OF THE NETHERLANDS

Number of pages

7

Pages from-to

97-103

UT code for WoS article

000401006600187

EID of the result in the Scopus database

2-s2.0-85018957258