Medizinische Universität Graz - Research portal
Selected Publication:
SHR Neuro Cancer Cardio Lipid Metab Microb
Riebandt, J; Haberl, T; Wiedemann, D; Moayedifar, R; Schloeglhofer, T; Mahr, S; Dimitrov, K; Angleitner, P; Laufer, G; Zimpfer, D.
Extracorporeal membrane oxygenation support for right ventricular failure after left ventricular assist device implantation.
Eur J Cardiothorac Surg. 2018; 53(3):590-595
Doi: 10.1093/ejcts/ezx349
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- Leading authors Med Uni Graz
- Zimpfer Daniel
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- Abstract:
- OBJECTIVES: Right ventricular (RV) failure complicating left ventricular assist device implantation is associated with increased mortality. Despite a lack of supporting evidence, venoarterial extracorporeal membrane oxygenation (ECMO) support is increasingly being used as an alternative to traditional temporary RV support. We report our institutional experience with ECMO-facilitated RV support after left ventricular assist device implantation. METHODS: We retrospectively reviewed the concept of temporary ECMO support for perioperative RV failure in 32 consecutive left ventricular assist device (mean age 52 ± 14 years; male 84.4%; ischaemic cardiomyopathy 40.6%; INTERMACS Level I 71.8%; INTERMACS Level II 6.3%; INTERMACS Level III 12.5%; INTERMACS Level IV-VII 9.4%; HeartWare ventricular assist device 75%; HeartMate II: 25%) from May 2009 to April 2014. The study end points were RV recovery during ECMO support, mortality and causes of death. RESULTS: Twenty-nine (90.6%) patients were successfully weaned from ECMO support after RV recovery. Three (9.4%) patients expired during ECMO support. ECMO support improved RV function and haemodynamic parameters (central venous pressure 13 mmHg vs 10 mmHg, P < 0.01; mean pulmonary artery pressure 28 mmHg vs 21 mmHg, P < 0.01; cardiac output 5.1 l/min vs 5.9 l/min, P = 0.09) over a median period of 3 (range 1-15) days. Thirty-day and in-hospital mortality were 18.8% and 25%, respectively. One-year survival was 75%, causes of death were multiorgan dysfunction syndrome (50%), sepsis (25%), haemorrhagic stroke (12.5%) and ischaemic stroke (12.5%). Causes of death during ECMO support were ischaemic stroke, sepsis and multiorgan dysfunction syndrome. CONCLUSIONS: Temporary ECMO-facilitated RV support is associated with good long-term outcomes and high rates of RV recovery.
- Find related publications in this database (using NLM MeSH Indexing)
- Adult - administration & dosage
- Aged - administration & dosage
- Extracorporeal Membrane Oxygenation - administration & dosage
- Female - administration & dosage
- Heart-Assist Devices - adverse effects
- Humans - administration & dosage
- Male - administration & dosage
- Middle Aged - administration & dosage
- Postoperative Complications - administration & dosage
- Retrospective Studies - administration & dosage
- Ventricular Dysfunction, Right - etiology, mortality, therapy
- Find related publications in this database (Keywords)
- Mechanical circulatory support
- Right heart failure
- Temporary right ventricular assist device
- Extracorporeal membrane oxygenation