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JOURNAL ARTICLE
B Ufuk Baldan, Romy R M J J Hegeman, Nelleke M J P Bos, Hans G Smeenk, Robert J M Klautz, Patrick Klein
Background : Post-cardiotomy cardiogenic shock (PCCS), which is defined as severe low cardiac output syndrome after cardiac surgery, has a mortality rate of up to 90%. No study has yet been performed to compare patients with PCCS treated by conservative means to patients receiving additional mechanical circulatory support with veno-arterial extracorporeal membrane oxygenation (ECMO). Methods : A single-center retrospective analysis from January 2018 to June 2022 was performed. Results : Out of 7028 patients who underwent cardiac surgery during this time period, 220 patients (3%) developed PCCS...
April 5, 2024: Journal of Clinical Medicine
#2
JOURNAL ARTICLE
Geoffroy Hariri, Xavier Luxey, Stefanie Wenger, Pauline Dureau, Sarah Hariri, Ahmed Charfeddine, Guillaume Lebreton, Nima Djavidi, Aymeric Lancelot, Baptiste Duceau, Adrien Bouglé
BACKGROUND: Monitoring fluid therapy is challenging in patients assisted with Veno-arterial ECMO. The aim of our study was to evaluate the usefulness of capillary refill time to assess the response to fluid challenge in patients assisted with VA-ECMO. METHODS: Retrospective monocentric study in a cardiac surgery ICU. We assess fluid responsiveness after a fluid challenge in patients on VA-ECMO. We recorded capillary refill time before and after fluid challenge and the evolution of global hemodynamic parameters...
March 9, 2024: Journal of Critical Care
#3
JOURNAL ARTICLE
Michael J Javorski, Karolis Bauza, Fei Xiang, Edward Soltesz, Lin Chen, Faisal G Bakaeen, Lars Svensson, Lucy Thuita, Eugene H Blackstone, Michael Z Tong
OBJECTIVES: To identify preoperative predictors of post-cardiotomy cardiogenic shock in patients with ischemic and non-ischemic cardiomyopathy and evaluate trajectory of postoperative ventricular function. METHODS: From 1/2017-1/2020, 238 patients with ejection fraction <30% (206/238) or 30-34% with at least moderately severe mitral regurgitation (32/238) underwent conventional cardiac surgery at Cleveland Clinic, 125 with ischemic and 113 with non-ischemic cardiomyopathy...
March 5, 2024: Journal of Thoracic and Cardiovascular Surgery
#4
JOURNAL ARTICLE
Sebastian D Sahli, Alexander Kaserer, Julia Braun, Raed Aser, Donat R Spahn, Markus J Wilhelm
BACKGROUND: Extracorporeal life support (ECLS) is pivotal for sustaining the function of failing hearts and lungs, and its utilization has risen. In cases where conventional cannulation strategies prove ineffective for providing adequate ECLS support, the implementation of an enhanced system with a third cannula may become necessary. Hybrid ECLS may be warranted in situations characterized by severe hypoxemia of the upper extremity, left ventricular congestion, and dilatation. Additionally, it may also be considered for patients requiring respiratory support or experiencing hemodynamic instability...
February 5, 2024: Journal of Personalized Medicine
#5
Benjamin D Seadler, Joshua Melamed, Mami Sow, Austin L Rogers, Ali Syed, Paul L Linsky, H Adam Ubert, Stefano Schena, Lucian A Durham, G Hossein Almassi
INTRODUCTION: For the Veterans Health Administration (VHA) to continue to perform complex cardiothoracic surgery, there must be an established pathway for providing urgent/emergent extracorporeal life support (ECLS). Partnership with a nearby tertiary care center with such expertise may be the most resource-efficient way to provide ECLS services to patients in post-cardiotomy cardiogenic shock or respiratory failure. The goal of this project was to assess the efficiency, safety, and outcomes of surgical patients who required transfer for perioperative ECLS from a single stand-alone Veterans Affairs Medical Center (VAMC) to a separate ECLS center...
February 6, 2024: Artificial Organs
#6
JOURNAL ARTICLE
Małgorzata Celińska-Spodar, Marta Załęska Kocięcka, Ilona Kowalik, Piotr Kołsut, Ewa Sitkowska-Rysiak, Jarosław Szymański, Janina Stępińska
BACKGROUND: While troponin is an established biomarker of cardiac injury, its prognostic significance in post-cardiotomy cardiogenic shock patients supported by venoarterial extracorporeal membrane oxygenation (PCCS-VA-ECMO) remains unclear. OBJECTIVE: This study aimed to assess the correlation between early post-operative troponin T levels and both short-term and long-term mortality outcomes in this cohort. METHODS: We evaluated 1457 troponin T measurements from 102 PCCS-VA-ECMO patients treated from 2013 to 2018 at a specialized cardio-surgical and transplantation center...
December 25, 2023: Diagnostics
#7
JOURNAL ARTICLE
Minimally Invasive Direct Aortic Implantation of Impella 5.5 As Bridge to Transplant: A Case Report.
Laura Dichiacchio, Joe Heiler, Hiroshi Kagawa, Craig H Selzman, Matthew L Goodwin
The use of temporary mechanical circulatory support in cardiogenic shock (CS) is increasing. The Impella (Abiomed) is a percutaneous, microaxial ventricular assist device approved for short-term use in CS that can be implanted peripherally. Direct aortic placement is an alternative commonly performed when the sternum is open, for example, in post-cardiotomy shock or when the peripheral vasculature is of insufficient size or quality for implantation. Herein, we describe direct aortic implantation of the Impella 5...
2024: Transplantation Proceedings
#8
Emmanuel Adrián Lazcano-Diaz, Karla Sue América Hurtado Belizario, Daniel Riveros-Nina, Aldo Pérez-Manjarrez, Daniel Manzur-Sandoval, Luis Baeza-Herrera, Gustavo Rojas-Velasco
We present the case of a 34-year-old male patient with a history of Marfan syndrome who was admitted to the emergency room for acute aortic regurgitation secondary to aneurysmal dilation of the ascending thoracic aorta. In the postoperative period, post-cardiotomy cardiogenic shock was documented, so circulatory support was initiated with peripheral Veno-Arterial ECMO, which developed hypoxemia due to bacterial pneumonia and data compatible with North-South syndrome. We present a review, non-conventional cannulation strategies and a diagnostic alternative for this entity...
2023: Arch Peru Cardiol Cir Cardiovasc
#9
JOURNAL ARTICLE
François-Xavier Hérion, Antoine Beurton, Claire Oddos, Karine Nubret, Clément Aguerreche, Astrid Quessard, Maxime Faure, Edouard Gerbaud, Mathieu Pernot, Julien Imbault, Alexandre Ouattara
BACKGROUND: Short-term mechanical circulatory support (STMCS) may be used as an intentional escalation strategy to treat cardiogenic shock refractory (rCS). However, with growing technical possibilities, making the right choice at the right time can be challenging. We established a shock team in January 2013 comprising a cardiac anaesthetist-intensivist, an interventional cardiologist, and a cardiac surgeon. Since then, a diagnosis of rCS has triggered a multidisciplinary team meeting based on a common algorithm...
September 15, 2023: European Heart Journal. Acute Cardiovascular Care
#10
JOURNAL ARTICLE
Marina Pieri, Matteo A Bonizzoni, Alessandro Belletti, Maria G Calabrò, Evgeny Fominskiy, Pasquale Nardelli, Alessandro Ortalda, Anna M Scandroglio
INTRODUCTION: Critically ill patients with inflammatory dysregulation and organ disfunction may benefit from blood purification, although the use of this technique has not been described in large case series. We evaluated clinical outcomes and survival in high-risk intensive care unit (ICU) patients who underwent extracorporeal blood purification. METHODS: 359 consecutive ICU patients treated with CytoSorb were included. RESULTS: Main admission diagnoses were 120 (34%) refractory cardiac arrest under mechanical chest compression; 101 (28%) profound cardiogenic shock; 81 (23%) post-cardiotomy cardiogenic shock; and 37 (10%) respiratory failure...
2023: Blood Purification
#11
JOURNAL ARTICLE
Juanjuan Shao, Chengcheng Shao, Yan Wang, Hongfu Fu, Jin Li, Xing Hao, Zhongtao Du, Chenglong Li, Liangshan Wang
BACKGROUND: Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is used as a rescue strategy for patients with refractory post-cardiotomy cardiogenic shock (PCS). These patients often have varying degrees of reduced hemoglobin levels, and there are few detailed investigations about the impact of hemoglobin level on their mortality. The objective of this study was to evaluate whether hemoglobin levels at day 1 from VA-ECMO initiation were associated with in-hospital mortality. METHODS: We performed a retrospective analysis of adult VA-ECMO patients over approximately a 2-year period...
August 2, 2023: Perfusion
#12
REVIEW
Jai Raman, Pankaj Saxena, Nikola Dobrilovic
INTRODUCTION: Extracorporeal membrane oxygenation (ECMO) in adults has been used in post-cardiotomy patients who decline hemodynamically. Cardiogenic shock in patients with potential surgically correctable cardiac conditions are at significantly higher risk for post-operative morbidity and mortality. We present experience with a pre-emptive approach of ECMO institution pre-operatively to stabilize patients with cardiogenic shock. MATERIALS AND METHODS: This study expands on a pilot study with a group of twenty patients who were supported with ECMO pre-operatively in different institutions over a period between 2011 and 2021...
July 2023: Indian Journal of Thoracic and Cardiovascular Surgery
#13
JOURNAL ARTICLE
Silvia Mariani, Anne-Kristin Schaefer, Bas C T van Bussel, Michele Di Mauro, Luca Conci, Philipp Szalkiewicz, Maria Elena De Piero, Samuel Heuts, Justine Ravaux, Iwan C C van der Horst, Diyar Saeed, Matteo Pozzi, Antonio Loforte, Udo Boeken, Robertas Samalavicius, Karl Bounader, Xiaotong Hou, Jeroen J H Bunge, Hergen Buscher, Leonardo Salazar, Bart Meyns, Daniel Herr, Sacha Matteucci, Sandro Sponga, Graeme MacLaren, Claudio Russo, Francesco Formica, Pranya Sakiyalak, Antonio Fiore, Daniele Camboni, Giuseppe Maria Raffa, Rodrigo Diaz, I-Wen Wang, Jae-Seung Jung, Jan Belohlavek, Vin Pellegrino, Giacomo Bianchi, Matteo Pettinari, Alessandro Barbone, José P Garcia, Glenn Whitman, Kiran Shekar, Dominik Wiedemann, Roberto Lorusso
BACKGROUND: Postcardiotomy venoarterial extracorporeal membrane oxygenation (VA ECMO) is characterized by discrepancies between weaning and survival-to-discharge rates. This study analyzes the differences between postcardiotomy VA ECMO patients who survived, died on ECMO, or died after ECMO weaning. Causes of death and variables associated with mortality at different time points are investigated. METHODS: The retrospective, multicenter, observational Postcardiotomy Extracorporeal Life Support Study (PELS) includes adults requiring postcardiotomy VA ECMO between 2000 and 2020...
November 2023: Annals of Thoracic Surgery
#14
JOURNAL ARTICLE
Silvia Mariani, Gabor Bari, Justine M Ravaux, Bas C T van Bussel, Maria Elena De Piero, Ann-Kristin Schaefer, Khalil Jawad, Matteo Pozzi, Antonio Loforte, Nikolaos Kalampokas, Agne Jankuviene, Erwan Flecher, Xiaotong Hou, Jeroen J H Bunge, Kogulan Sriranjan, Leonardo Salazar, Bart Meyns, Michael A Mazzeffi, Sacha Matteucci, Sandro Sponga, Kollengode Ramanathan, Alessandro Costetti, Francesco Formica, Pranya Sakiyalak, Antonio Fiore, Chistof Schmid, Giuseppe Maria Raffa, Roberto Castillo, I-Wen Wang, Jae-Seung Jung, Tomas Grus, Vin Pellegrino, Giacomo Bianchi, Matteo Pettinari, Alessandro Barbone, José P Garcia, Mariusz Kowalewski, Kiran Shekar, Glenn Whitman
BACKGROUND: High-quality evidence for post-cardiotomy extracorporeal life support (PC-ECLS) management is lacking. This study investigated the real-world PC-ECLS clinical practices. METHODS: This cross-sectional, multi-institutional, international pilot survey explored center organization, anticoagulation management, left ventricular unloading, distal limb perfusion, PC-ECLS monitoring and transfusions practices. Twenty-nine questions were distributed among 34 hospitals participating in the Post-cardiotomy Extra-Corporeal Life Support Study...
June 23, 2023: Artificial Organs
#15
MULTICENTER STUDY
Silvia Mariani, I-Wen Wang, Bas C T van Bussel, Samuel Heuts, Dominik Wiedemann, Diyar Saeed, Iwan C C van der Horst, Matteo Pozzi, Antonio Loforte, Udo Boeken, Robertas Samalavicius, Karl Bounader, Xiaotong Hou, Jeroen J H Bunge, Hergen Buscher, Leonardo Salazar, Bart Meyns, Daniel Herr, Sacha Matteucci, Sandro Sponga, Kollengode Ramanathan, Claudio Russo, Francesco Formica, Pranya Sakiyalak, Antonio Fiore, Daniele Camboni, Giuseppe Maria Raffa, Rodrigo Diaz, Jae-Seung Jung, Jan Belohlavek, Vin Pellegrino, Giacomo Bianchi, Matteo Pettinari, Alessandro Barbone, José P Garcia, Kiran Shekar, Glenn Whitman, Roberto Lorusso
OBJECTIVES: Postcardiotomy extracorporeal membrane oxygenation (ECMO) can be initiated intraoperatively or postoperatively based on indications, settings, patient profile, and conditions. The topic of implantation timing only recently gained attention from the clinical community. We compare patient characteristics as well as in-hospital and long-term survival between intraoperative and postoperative ECMO. METHODS: The retrospective, multicenter, observational Postcardiotomy Extracorporeal Life Support (PELS-1) study includes adults who required ECMO due to postcardiotomy shock between 2000 and 2020...
December 2023: Journal of Thoracic and Cardiovascular Surgery
#16
JOURNAL ARTICLE
Leonie Schmack, Bastian Schmack, Maria Papathanasiou, Fadi Al-Rashid, Alexander Weymann, Nikolaus Pizanis, Markus Kamler, Arjang Ruhparwar, Tienush Rassaf, Peter Luedike
BACKGROUND: Percutaneous extracorporeal life support (pECLS) is increasingly applied in cardiogenic shock (CS) despite a lack of evidence from randomized trials. The in-hospital mortality rate of pECLS still reaches up to 60%, while vascular access site complications remain a shortcoming. Surgical approaches with central cannulation for ECLS (cELCS) have emerged as a bail-out option. To date, no systematic approach exists that allows a definition of inclusion or exclusion criteria for cECLS...
2023: Frontiers in Cardiovascular Medicine
#17
JOURNAL ARTICLE
Sameer K Singh, Megan M Chung, Koji Takeda, Hiroo Takayama
No abstract text is available yet for this article.
April 14, 2023: Annals of Thoracic Surgery
#18
JOURNAL ARTICLE
Giulio Massimi, Matteo Matteucci, Michele De Bonis, Mariusz Kowalewski, Francesco Formica, Claudio Francesco Russo, Sandro Sponga, Ivan Vendramin, Andrea Colli, Giosuè Falcetta, Cinzia Trumello, Massimiliano Carrozzini, Theodor Fischlein, Giovanni Troise, Guglielmo Actis Dato, Stefano D'Alessandro, Peyman Sardari Nia, Vittoria Lodo, Emmanuel Villa, Shabir Hussain Shah, Roberto Scrofani, Irene Binaco, Jurij Matija Kalisnik, Matteo Pettinari, Matthias Thielmann, Bart Meyns, Fareed A Khouqeer, Carlo Fino, Caterina Simon, Paolo Severgnini, Adam Kowalowka, Marek A Deja, Daniele Ronco, Roberto Lorusso
BACKGROUND: Post-acute myocardial infarction papillary muscle rupture (post-AMI PMR) may present variable clinical scenarios and degree of emergency due to result of cardiogenic shock. Veno-arterial extracorporeal life support (V-A ECLS) has been proposed to improve extremely poor pre- or post-operative conditions. Information in this respect is scarce. METHODS: From the CAUTION (meChanical complicAtion of acUte myocardial infarcTion: an InternatiOnal multiceNter cohort study) database (16 different Centers, data from 2001 to 2018), we extracted adult patients who were surgically treated for post-AMI PMR and underwent pre or/and postoperative V-A ECLS support...
April 11, 2023: Artificial Organs
#19
REVIEW
Mridul Bansal, Aryan Mehta, Patrick M Wieruszewski, P Matthew Belford, David X Zhao, Ashish K Khanna, Saraschandra Vallabhajosyula
BACKGROUND: Cardiogenic shock (CS) is associated with high morbidity and mortality. In recent times, there is increasing interest in the role of angiotensin II in CS. We sought to systematically review the current literature on the use of angiotensin II in CS. METHODS: PubMed, EMBASE, Medline, Web of Science, PubMed Central, and CINAHL databases were systematically searched for studies that evaluated the efficacy of angiotensin II in patients with CS during 01/01/2010-07/07/2022...
April 2023: American Journal of Emergency Medicine
#20
JOURNAL ARTICLE
Sanket Mehta, Justin Fried, Samantha Nemeth, Paul Kurlansky, Yuji Kaku, Andrew Melehy, Steven Char, Amirali Masoumi, Gabriel Sayer, Nir Uriel, Koji Takeda
We applied the Society for Cardiovascular Angiography and Interventions (SCAI) schema to cardiogenic shock (CS) patients treated with venoarterial extracorporeal membrane oxygenation (VA-ECMO) to assess performance in this high acuity group of patients. Records of adult patients receiving VA-ECMO for CS at our institution from 01/2015 to 12/2019 were reviewed. Post-cardiotomy and noncardiogenic shock patients were excluded. A total of 245 patients were included, with a median age of 59 years [IQR: 48-67]; 159 (65%) were male...
October 13, 2022: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
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