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Saeed, D; Potapov, E; Loforte, A; Morshuis, M; Schibilsky, D; Zimpfer, D; Riebandt, J; Pappalardo, F; Attisani, M; Rinaldi, M; Haneya, A; Ramjankhan, F; Donker, DW; Jorde, UP; Stein, J; Tsyganenko, D; Jawad, K; Wieloch, R; Ayala, R; Cremer, J; Borger, MA; Lichtenberg, A; Gummert, J, , Durable, MCS, after, ECLS, Study, Group.
Transition From Temporary to Durable Circulatory Support Systems.
J Am Coll Cardiol. 2020; 76(25): 2956-2964.
Doi: 10.1016/j.jacc.2020.10.036
Web of Science
PubMed
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- Co-authors Med Uni Graz
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Zimpfer Daniel
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- Abstract:
- BACKGROUND: The decision to implant durable mechanical circulatory systems (MCSs) in patients on extracorporeal life support (ECLS) is challenging due to expected poor outcomes in these patients. OBJECTIVES: The aim of this study was to identify outcome predictors that may facilitate future patient selection and decision making. METHODS: The Durable MCS after ECLS registry is a multicenter retrospective study that gathered data on consecutive patients who underwent MCS implantation after ECLS between January 2010 and August 2018 in 11 high-volume European centers. Several perioperative parameters were collected. The primary endpoint was survival at 1 year after durable MCS implantation. RESULTS: A total of 531 durable MCSs after ECLS were implanted during this period. The average patient age was 53 ± 12 years old. ECLS cannulation was peripheral in 87% of patients and 33% of the patients had history of cardiopulmonary resuscitation before ECLS implantation. The 30-day, 1-year, and 3-year actuarial survival rates were 77%, 53%, and 43%, respectively. The following predictors for 1-year outcome have been observed: age, female sex, lactate value, Model of End-Stage Liver Disease XI score, history of atrial fibrillation, redo surgery, and body mass index >30 kg/m2. On the basis of this data, a risk score and an app to estimate 1-year mortality was created. CONCLUSIONS: The outcome in patients receiving durable MCS after ECLS remains limited, yet preoperative factors may allow differentiating futile patients from those with significant survival benefit.
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Cardiopulmonary Resuscitation - methods
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Clinical Decision-Making - methods
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Europe - epidemiology
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Extracorporeal Membrane Oxygenation - instrumentation, methods, statistics & numerical data
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Female - administration & dosage
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Heart-Assist Devices - statistics & numerical data
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Humans - administration & dosage
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Male - administration & dosage
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Middle Aged - administration & dosage
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Mortality - administration & dosage
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Patient Selection - administration & dosage
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Prognosis - administration & dosage
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Registries - statistics & numerical data
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Retrospective Studies - administration & dosage
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Risk Factors - administration & dosage
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Shock, Cardiogenic - physiopathology, therapy
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Survival Rate - administration & dosage
- Find related publications in this database (Keywords)
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extracorporeal life support
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extracorporeal membrane oxygenation
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mechanical circulatory support
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outcome
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predictors