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Annals of Cardiothoracic Surgery

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https://read.qxmd.com/read/30854330/weaning-from-veno-arterial-extra-corporeal-membrane-oxygenation-which-strategy-to-use
#1
EDITORIAL
Sofia Ortuno, Clément Delmas, Jean-Luc Diehl, Clotilde Bailleul, Aymeric Lancelot, Mahassen Naili, Bernard Cholley, Romain Pirracchio, Nadia Aissaoui
Refractory cardiogenic shock patients may be rescued by veno-arterial extracorporeal membrane oxygenation (VA ECMO). After a few days of mechanical assistance, the device can sometimes be successfully removed if the patient has partially or fully recovered from the condition that required the use of ECMO. The percentage of patients with refractory cardiogenic shock who are successfully weaned from ECMO varies from 31% to 76%. Weaning does not mean survival, because 20% to 65% of patients weaned from VA ECMO support do not survive to hospital discharge...
January 2019: Annals of Cardiothoracic Surgery
https://read.qxmd.com/read/30854329/extracorporeal-membrane-oxygenation-for-right-ventricular-support-in-left-ventricular-assist-device-recipients
#2
EDITORIAL
Julia Riebandt, Roxana Moayedifar, Günther Laufer, Daniel Zimpfer
No abstract text is available yet for this article.
January 2019: Annals of Cardiothoracic Surgery
https://read.qxmd.com/read/30854328/preoperative-and-intraoperative-extracorporeal-membrane-oxygenation-adoption-for-long-term-left-ventricular-assist-device-implantation
#3
EDITORIAL
Bujar Maxhera, Nihat Firat Sipahi, Alexander Albert, Udo Boeken, Artur Lichtenberg, Diyar Saeed
No abstract text is available yet for this article.
January 2019: Annals of Cardiothoracic Surgery
https://read.qxmd.com/read/30854327/percutaneous-pulmonary-artery-venting-via-jugular-vein-while-on-peripheral-extracorporeal-membrane-oxygenation-running-a-less-invasive-approach-to-provide-full-biventricular-unloading
#4
EDITORIAL
Antonio Loforte, Massimo Baiocchi, Gregorio Gliozzi, Giuditta Coppola, Roberto Di Bartolomeo, Roberto Lorusso
No abstract text is available yet for this article.
January 2019: Annals of Cardiothoracic Surgery
https://read.qxmd.com/read/30854326/concomitant-use-of-impella-while-on-peripheral-veno-arterial-extracorporeal-membrane-oxygenation-de-escalate-and-ambulate
#5
EDITORIAL
Letizia Fausta Bertoldi, Luca Bertoglio, Federico Pappalardo
No abstract text is available yet for this article.
January 2019: Annals of Cardiothoracic Surgery
https://read.qxmd.com/read/30854325/double-triple-and-quadruple-cannulation-for-veno-arterial-extracorporeal-membrane-oxygenation-support-is-there-a-limit
#6
EDITORIAL
Daniele Camboni, Alois Philip, Christof Schmid, Antonio Loforte
Each cannulation strategy for venoarterial extracorporeal membrane oxygenation (VA ECMO) has distinct benefits and drawbacks. In this article, various cannulation strategies including their indications are discussed. The gold standard for cannulation involves peripheral, percutaneous double cannulation utilizing the patient's femoral vein and artery. In emergency situations under mechanical resuscitation, a simple and fast cannulation technique is crucial to reestablish circulation. This is usually performed percutaneously utilizing the femoral approach...
January 2019: Annals of Cardiothoracic Surgery
https://read.qxmd.com/read/30854324/short-term-mechanical-circulatory-support-as-bridge-to-heart-transplantation-paracorporeal-ventricular-assist-device-as-alternative-to-extracorporeal-life-support
#7
EDITORIAL
Sandro Sponga, Giovanni Benedetti, Ugolino Livi
Extracorporeal life support (ECLS) is generally considered to be the treatment of choice for bridging to heart transplantation (HTx) patients with cardiogenic shock; however, alternative mechanical circulatory support (MCS) devices have been proposed with satisfactory results and, among those, paracorporeal systems have demonstrated to be safe and effective. This technology has been used for decades as bridge to transplant, especially in patients with advanced right ventricular dysfunction or evidence of multiorgan failure (MOF), which could be difficult to manage with an isolated left ventricular support...
January 2019: Annals of Cardiothoracic Surgery
https://read.qxmd.com/read/30854323/extracorporeal-membrane-oxygenation-for-accidental-deep-hypothermia-current-challenges-and-future-perspectives
#8
EDITORIAL
Piotr Mazur, Sylweriusz Kosiński, Paweł Podsiadło, Anna Jarosz, Roman Przybylski, Radosław Litiwnowicz, Jacek Piątek, Janusz Konstanty-Kalandyk, Robert Gałązkowski, Tomasz Darocha
The incidence of accidental hypothermia (core temperature ≤35 °C) is difficult to estimate, as the affected population is heterogeneous. Both temperature and clinical presentation should be considered while determining severity, which is difficult in a prehospital setting. Extracorporeal rewarming is advocated for all Swiss Staging System class IV (hypothermic cardiac arrest) and class III (hypothermic cardiac instability) patients. Veno-arterial extracorporeal membrane oxygenation (ECMO) is the method of choice, as it not only allows a gradual, controlled increase of core body temperature, but also provides respiratory and hemodynamic support during the unstable period of rewarming and reperfusion...
January 2019: Annals of Cardiothoracic Surgery
https://read.qxmd.com/read/30854322/traditional-and-non-traditional-anticoagulation-management-during-extracorporeal-membrane-oxygenation
#9
EDITORIAL
Andreas Koster, Edis Ljajikj, David Faraoni
Unfractionated heparin (UFH) is the anticoagulant of choice during extracorporeal membrane oxygenation (ECMO) support. Despite its favorable pharmacologic properties, management of heparin anticoagulation during ECMO remains a major challenge. To date, little is known about the optimal monitoring strategy or the heparin dose offering the best safety/efficacy profile. Therefore, it remains unclear if the heparin dose should be adapted to target a specific "clotting time" [e.g., activated clotting time (ACT) or activated partial thromboplastin time (aPTT)] or a heparin concentration, measured by coagulation factor anti-Xa assay...
January 2019: Annals of Cardiothoracic Surgery
https://read.qxmd.com/read/30854321/cardiac-catheterization-and-percutaneous-intervention-procedures-on-extracorporeal-membrane-oxygenation-support
#10
EDITORIAL
Cesar Y Guerrero-Miranda, Shelley A Hall
Extracorporeal membrane oxygenation (ECMO) is used to support critically ill patients when conventional therapies have failed. ECMO has been available for four decades and has gained use as a rescue therapy in severe refractory hypoxic disorders and in patients with refractory cardiogenic shock (RCS). Over recent years, several percutaneous cardiac interventions and implant devices have been developed that are now used frequently in conjunction with ECMO in order to maintain organ perfusion. Here, we review the literature on VA-ECMO cannulation location, the use of VA-ECMO in interventions (e...
January 2019: Annals of Cardiothoracic Surgery
https://read.qxmd.com/read/30854320/long-term-survival-and-major-outcomes-in-post-cardiotomy-extracorporeal-membrane-oxygenation-for-adult-patients-in-cardiogenic-shock
#11
EDITORIAL
Paolo Meani, Matteo Matteucci, Federica Jiritano, Dario Fina, Francesco Panzeri, Giuseppe M Raffa, Mariusz Kowalewski, Nuccia Morici, Giovanna Viola, Alice Sacco, Fabrizio Oliva, Amal Alyousif, Sam Heuts, Martijn Gilbers, Rick Schreurs, Jos Maessen, Roberto Lorusso
Extracorporeal membrane oxygenation (ECMO) in the veno-arterial (VA) configuration is an established method for the treatment of refractory cardiogenic shock. Such a condition characterizes the postoperative course of approximatively 1% of cardiac surgery patients. Although some studies have reported ECMO-related short-term results, little is known about the long-term outcomes of VA-ECMO therapy in the post-cardiotomy setting. Therefore, an extensive literature search was conducted regarding articles published after 1990 reporting postoperative ECMO use...
January 2019: Annals of Cardiothoracic Surgery
https://read.qxmd.com/read/30854319/extracorporeal-membrane-oxygenation-support-in-pediatrics
#12
EDITORIAL
Tugba Erdil, Frithjof Lemme, Alexander Konetzka, Anna Cavigelli-Brunner, Oliver Niesse, Hitendu Dave, Peter Hasenclever, Michael Hübler, Martin Schweiger
Extracorporeal membrane oxygenation (ECMO) is a general term that describes the short- or long-term support of the heart and/or lungs in neonates, children and adults. Due to favorable results and a steady decline in absolute contraindications, its use is increasing worldwide. Indications in children differ from those in adults. The ECMO circuit as well as cannulation strategies also are individualized, considering their implications in children. The aim of this article is to review the clinical indications, different circuits, and cannulation strategies for ECMO...
January 2019: Annals of Cardiothoracic Surgery
https://read.qxmd.com/read/30854318/extracorporeal-membrane-oxygenation-as-treatment-of-graft-failure-after-heart-transplantation
#13
EDITORIAL
Ciro Mastroianni, Antonio Nenna, Guillaume Lebreton, Cosimo D'Alessandro, Salvatore Matteo Greco, Mario Lusini, Pascal Leprince, Massimo Chello
Heart transplantation (HTx) is a valuable option in eligible patients with end-stage heart failure. The most significant complication in the immediate post-operative period is early graft failure (EGF), with a mean incidence of 20-25%. EGF is a major risk factor for death and accounts for 40-50% of early mortality after HTx. Despite the use of inotropes, EGF may persist and require temporary mechanical circulatory support. Extracorporeal membrane oxygenation (ECMO) has been investigated over the years and has proved to be a reliable strategy in patients with EGF after HTx...
January 2019: Annals of Cardiothoracic Surgery
https://read.qxmd.com/read/30854317/the-extracorporeal-life-support-organization-registry-update-and-perspectives
#14
EDITORIAL
Roberto Lorusso, Peta Alexander, Peter Rycus, Ryan Barbaro
From the birth of the Extracorporeal Life Support Organization (ELSO) Registry in 1989, collecting the most relevant information about extracorporeal life support (ECLS) for refractory cardiac or respiratory compromise, was created in order to provide useful information and benchmark for ECLS users. Throughout the years, the Registry has continuously developed, achieving in 2018 more than 100,000 patients included with almost 500 ELSO centers around the world. Based on the relevance and impact of database analysis, and due to the growing need for more advanced and high-quality clinical investigations, the ELSO Registry is under substantial re-engineering which will allow and provide the ELSO members and the scientific community an enhanced scientific tool to elucidate various aspects of the ECLS settings, including trends and disease-specific information, to perform benchmarking about our own results and outcomes as compared to regional or worldwide results, and to provide an invaluable source of data for clinical investigations...
January 2019: Annals of Cardiothoracic Surgery
https://read.qxmd.com/read/30854316/role-and-management-of-extracorporeal-life-support-after-surgery-of-chronic-thromboembolic-pulmonary-hypertension
#15
Sofia Martin-Suarez, Gregorio Gliozzi, Mariafrancesca Fiorentino, Antonio Loforte, Valentina Ghigi, Marcello Di Camillo, Nazareno Galiè, Davide Pacini
Background: Pulmonary endarterectomy (PEA) is a surgical intervention reserved for patients with chronic thromboembolic pulmonary hypertension (CTEPH). In some cases, temporary circulatory support [extracorporeal life support (ECLS)] is required after PEA. Rates of ECLS requirement varies between centers. Reasons for institution of ECLS include respiratory failure, cardiac failure (or both respiratory and cardiac failure), bleeding, and reperfusion edema. This article reviews the experience of ECLS after PEA from the current literature, as well as our own institution's experience as a CTEPH multidisciplinary center...
January 2019: Annals of Cardiothoracic Surgery
https://read.qxmd.com/read/30854315/temporary-mechanical-circulatory-support-for-refractory-heart-failure-the-german-heart-center-berlin-experience
#16
Gaik Nersesian, Felix Hennig, Marcus Müller, Johanna Mulzer, Dmytro Tsyganenko, Christoph Starck, Tom Gromann, Volkmar Falk, Evgenij Potapov, Felix Schoenrath
Background: Temporary mechanical circulatory support (MCS) offers a valuable option for treatment of refractory heart failure. We present our experience with selected MCS devices in cardiogenic shock of different etiologies. Methods: We retrospectively studied patients who were treated in our institution between 01/2016 and 07/2018. Patients receiving only veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support were excluded. Left ventricular support patients received Impella; right ventricular support was conducted using Levitronix CentriMag...
January 2019: Annals of Cardiothoracic Surgery
https://read.qxmd.com/read/30854314/adult-cardiac-veno-arterial-extracorporeal-life-support-va-ecmo-prevention-and-management-of-acute-complications
#17
Michael M Koerner, Michael D Harper, Christopher K Gordon, Douglas Horstmanshof, James W Long, Michael J Sasevich, James D Neel, Aly El Banayosy
Background: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has been shown to be a viable and effective treatment for patients suffering from refractory cardiogenic shock (rCS), which is associated with high mortality rates. Although ECMO therapy used as short-term mechanical circulatory support (MCS) has shown tremendous growth in its application over the past decade, the complication and mortality rates remain high. This retrospective study analyzes complications associated with VA-ECMO support, evaluates the use of defined protocols at a single center, and examines factors that may contribute to patient complication and mortality...
January 2019: Annals of Cardiothoracic Surgery
https://read.qxmd.com/read/30854313/inter-hospital-transfer-of-extracorporeal-membrane-oxygenation-assisted-patients-the-hub-and-spoke-network
#18
Michiel Morshuis, Frank Bruenger, Tobias Becker, Annette Kempa-Haupt, Lukasz Kizner, Riad Al-Khalil, Jan F Gummert, René Schramm
Background: The treatment of cardiogenic shock (CS) in peripheral hospitals may be challenging when acute mechanical circulatory support (MCS) is not available. Tertiary care centers may provide mobile extracorporeal membrane oxygenation (ECMO) teams to support the treatment of CS-patients externally. Methods: We retrospectively analyzed our single-center experience with a mobile ECMO team focussing on decision-making and survival data of CS-patients retrieved by ECMO support from peripheral hospitals to our tertiary care center between January 2012 and October 2018...
January 2019: Annals of Cardiothoracic Surgery
https://read.qxmd.com/read/30854312/extracorporeal-membrane-oxygenation-after-lung-transplantation-risk-factors-and-outcomes-analysis
#19
Massimo Boffini, Erika Simonato, Davide Ricci, Fabrizio Scalini, Matteo Marro, Stefano Pidello, Matteo Attisani, Paolo Solidoro, Paolo Olivo Lausi, Vito Fanelli, Cristina Barbero, Luca Brazzi, Mauro Rinaldi
Background: Lung transplantation is the treatment of choice for end-stage pulmonary disease in selected patients. However, severe primary graft dysfunction is a significant complication of transplant and requires the implantation of an extracorporeal support. The aim of the study is to evaluate the impact of extracorporeal membrane oxygenation (ECMO) after transplant in our center. Methods: From January 2008 till June 2018, 195 consecutive unselected patients receiving a lung transplant were considered...
January 2019: Annals of Cardiothoracic Surgery
https://read.qxmd.com/read/30854311/awake-and-fully-mobile-patients-on-cardiac-extracorporeal-life-support
#20
REVIEW
Darryl Abrams, A Reshad Garan, Daniel Brodie
Early mobilization of critically ill patients is increasingly being recognized as not only safe and feasible, but also as a potential means of optimizing outcomes in the intensive care unit (ICU). With the rapidly expanding use of extracorporeal life support (ECLS) for severe cardiopulmonary failure, there is a growing interest in the application of early mobilization to this patient population, which has been shown to be safe and feasible in select patient populations. However, some patients receiving ECLS support may benefit more than others...
January 2019: Annals of Cardiothoracic Surgery
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