TY - JOUR
T1 - Rescue extracorporeal life support as a bridge to durable left ventricular assist device
AU - Zubarevich, Alina
AU - Zhigalov, Konstantin
AU - Szczechowicz, Marcin
AU - Arjomandi Rad, Arian
AU - Vardanyan, Robert
AU - Torabi, Saeed
AU - Papathanasiou, Maria
AU - Luedike, Peter
AU - Koch, Achim
AU - Pizanis, Nikolaus
AU - Kamler, Markus
AU - Schmack, Bastian
AU - Ruhparwar, Arjang
AU - Weymann, Alexander
PY - 2022/4
Y1 - 2022/4
N2 - BACKGROUND: The ideal timing of a durable assist device implantation in patients with end-stage heart failure presenting with INTERMACS profile I is still controversial. The data on extracorporeal life support (ECLS) bridge to durable left ventricular assist device (LVAD) in these patients is limited.MATERIALS AND METHODS: We retrospectively analyzed the outcomes of 35 patients in acute cardiogenic shock (CS) who, between December 2013 and September 2020, were bridged with ECLS to durable LVAD. The mean age was 52.3 ± 12.0 years. The primary endpoints of this study were in-hospital, 30-day, 6-month, and 1-year mortality. The secondary endpoint was the development of any postoperative adverse events and other characteristics during the follow-up period. We also assessed the impact of the rescue ECLS on the recovery of the end-organ function.RESULTS: In-hospital, 30-day, 6-month, and 1-year survival was 65.6%, 75.9%, 69.2%, and 62.7% respectively. The median time on ECLS was 7 days (IQR 5.0-13.0). We observed a high incidence of a severe right heart failure (22.9%), acute kidney injury on dialysis (68.6%), and respiratory failure (77.1%). Bridge with ECLS provided a significant recovery of liver and kidney function prior to durable LVAD implantation.CONCLUSION: The concept of bridging patients presenting in end-stage heart failure and cardiogenic shock with ECLS prior to durable LVAD implantation is a feasible method to ensure acceptable survival rates and significant recovery of the end-organ function.
AB - BACKGROUND: The ideal timing of a durable assist device implantation in patients with end-stage heart failure presenting with INTERMACS profile I is still controversial. The data on extracorporeal life support (ECLS) bridge to durable left ventricular assist device (LVAD) in these patients is limited.MATERIALS AND METHODS: We retrospectively analyzed the outcomes of 35 patients in acute cardiogenic shock (CS) who, between December 2013 and September 2020, were bridged with ECLS to durable LVAD. The mean age was 52.3 ± 12.0 years. The primary endpoints of this study were in-hospital, 30-day, 6-month, and 1-year mortality. The secondary endpoint was the development of any postoperative adverse events and other characteristics during the follow-up period. We also assessed the impact of the rescue ECLS on the recovery of the end-organ function.RESULTS: In-hospital, 30-day, 6-month, and 1-year survival was 65.6%, 75.9%, 69.2%, and 62.7% respectively. The median time on ECLS was 7 days (IQR 5.0-13.0). We observed a high incidence of a severe right heart failure (22.9%), acute kidney injury on dialysis (68.6%), and respiratory failure (77.1%). Bridge with ECLS provided a significant recovery of liver and kidney function prior to durable LVAD implantation.CONCLUSION: The concept of bridging patients presenting in end-stage heart failure and cardiogenic shock with ECLS prior to durable LVAD implantation is a feasible method to ensure acceptable survival rates and significant recovery of the end-organ function.
KW - Adult
KW - Extracorporeal Membrane Oxygenation
KW - Heart Failure/surgery
KW - Heart-Assist Devices
KW - Humans
KW - Middle Aged
KW - Retrospective Studies
KW - Shock, Cardiogenic
KW - Treatment Outcome
U2 - 10.1177/03913988211053874
DO - 10.1177/03913988211053874
M3 - Article
C2 - 34674570
SN - 0391-3988
VL - 45
SP - 371
EP - 378
JO - International Journal of Artificial Organs
JF - International Journal of Artificial Organs
IS - 4
ER -