The use of extracorporeal membrane oxygenation in the setting of postinfarction mechanical complications: outcome analysis of the Extracorporeal Life Support Organization Registry

M. Matteucci*, D. Fina, F. Jiritano, P. Meani, G.M. Raffa, M. Kowalewski, I. Aldobayyan, M. Turkistani, C. Beghi, R. Lorusso

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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OBJECTIVES:Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has been recently considered and used for patients with post-acute myocardial infarction mechanical complications (post-AMI MC); however, information in this respect is scarce. The purpose of this study was to evaluate the in-hospital outcomes of patients with post-AMI MC submitted to VA-ECMO, and enrolled in the Extracorporeal Life Support Organizations (ELSO)'s data Registry.METHODS: This was a retrospective review of the ELSO Registry to identify adult (>18years old) patients with post-AMI MC who underwent VA-ECMO support between 2007 and 2018. The primary end point of this study was in-hospital survival. ECMO complications were also evaluated.RESULTS: The patient cohort available for this study included 158 patients. The median age was 62.4years (range 20-80). The most common post-AMI MC was ventricular septal rupture (n=102; 64.5%), followed by papillary muscle rupture (n=42; 26.6%) and ventricular free-wall rupture (n=14; 8.9%). Approximately a quarter of patients (n=41; 25.9%) had cardiac arrest before VA-ECMO institution. The median duration of VA-ECMO was 5.9days (range 1h-40.3days). ECMO complications occurred in 119 patients (75.3%). Overall, survival to hospital discharge for the entire patient cohort was 37.3%. Patients who had ventricular septal rupture as primary diagnosis had higher in-hospital mortality (n=66; 64.7%).CONCLUSIONS: In patients with post-AMI MC, VA-ECMO provides haemodynamic stabilizations and carries a potential to reverse otherwise lethal course. ECMO complications, however, remain an important limitation. Further investigations are required to better evaluate the efficacy and safety of ECMO in this context.
Original languageEnglish
Pages (from-to)369-374
Number of pages6
JournalInteractive Cardiovascular and Thoracic Surgery
Issue number3
Publication statusPublished - 1 Sep 2020


  • acute myocardial infarction
  • cardiac arrest
  • cardiac-arrest
  • cardiogenic shock
  • cardiogenic-shock
  • circulatory support
  • elevation myocardial-infarction
  • era
  • extracorporeal membrane oxygenation
  • mechanical complications
  • metaanalysis
  • mortality
  • rupture
  • surgical repair
  • trends
  • Extracorporeal membrane oxygenation
  • Cardiogenic shock
  • Cardiac arrest
  • ERA
  • Mechanical complications
  • Acute myocardial infarction

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