PMID- 32083665
OWN - NLM
STAT- MEDLINE
DCOM- 20210621
LR  - 20210621
IS  - 1873-734X (Electronic)
IS  - 1010-7940 (Linking)
VI  - 58
IP  - 2
DP  - 2020 Aug 1
TI  - Preclosing of the femoral artery allows total percutaneous venoarterial 
      extracorporeal membrane oxygenation and prevents groin wound infection after lung 
      transplantation.
PG  - 371-378
LID - 10.1093/ejcts/ezaa039 [doi]
AB  - OBJECTIVES: In lung transplantation (LT), femoral venoarterial extracorporeal 
      membrane oxygenation (VA-ECMO) usually requires an open approach that may be 
      associated with severe groin wound infection. In endovascular aortic procedures, 
      preclosing of the femoral artery (PFA) with vascular closure devices allows the 
      percutaneous insertion and withdrawal of large-bore cannulae. We sought to 
      evaluate whether this innovative technique could be applied in the specific 
      setting of LT to achieve total percutaneous VA-ECMO and decrease groin wound 
      infection. METHODS: We conducted a retrospective study of a prospective database 
      including patients who underwent LT in our centre from January 2011 to December 
      2017. Patients who underwent peripheral VA-ECMO using the PFA technique after 
      January 2014 (PFA group, n = 106) were compared to those who underwent peripheral 
      VA-ECMO using open cannulation and/or decannulation before January 2014 (non-PFA 
      group, n = 48). The primary end point was the rate of technical success defined 
      as total percutaneous VA-ECMO. Secondary end points included groin wound 
      infections and delayed vascular complications. RESULTS: The PFA technique was 
      technically successful in 98 patients (92.5%). As compared with the non-PFA 
      group, the PFA group was characterized by a similar rate of vascular 
      complications (16.6% vs 11.3%, P = 0.360) and a decreased rate of groin wound 
      infection (18.9% vs 0%, P < 0.001). In multivariate analysis, risk factors 
      associated with vascular complications following PFA included female sex, 
      peripheral arterial disease and ECMO duration. CONCLUSIONS: In LT patients, PFA 
      is associated with a high rate of total percutaneous VA-ECMO, thus preventing the 
      occurrence of groin wound infection.
CI  - (c) The Author(s) 2020. Published by Oxford University Press on behalf of the 
      European Association for Cardio-Thoracic Surgery. All rights reserved.
FAU - Pellenc, Quentin
AU  - Pellenc Q
AD  - Service de Chirurgie Vasculaire, Thoracique, et Transplantation Pulmonaire, 
      Bichat Hospital, Paris University, Paris, France.
FAU - Girault, Antoine
AU  - Girault A
AD  - Service de Chirurgie Vasculaire, Thoracique, et Transplantation Pulmonaire, 
      Bichat Hospital, Paris University, Paris, France.
FAU - Roussel, Arnaud
AU  - Roussel A
AD  - Service de Chirurgie Vasculaire, Thoracique, et Transplantation Pulmonaire, 
      Bichat Hospital, Paris University, Paris, France.
FAU - Aguir, Sonia
AU  - Aguir S
AD  - Service de Chirurgie Vasculaire, Thoracique, et Transplantation Pulmonaire, 
      Bichat Hospital, Paris University, Paris, France.
FAU - Cerceau, Pierre
AU  - Cerceau P
AD  - Service de Chirurgie Vasculaire, Thoracique, et Transplantation Pulmonaire, 
      Bichat Hospital, Paris University, Paris, France.
FAU - Longrois, Dan
AU  - Longrois D
AD  - Departement d'Anesthesie-Reanimation, Bichat Hospital, Paris University, Paris, 
      France.
FAU - Mal, Herve
AU  - Mal H
AD  - Service de Pneumologie B et Transplantation Pulmonaire, Bichat Hospital, Paris 
      University, Paris, France.
FAU - Mordant, Pierre
AU  - Mordant P
AD  - Service de Chirurgie Vasculaire, Thoracique, et Transplantation Pulmonaire, 
      Bichat Hospital, Paris University, Paris, France.
FAU - Castier, Yves
AU  - Castier Y
AD  - Service de Chirurgie Vasculaire, Thoracique, et Transplantation Pulmonaire, 
      Bichat Hospital, Paris University, Paris, France.
LA  - eng
PT  - Journal Article
PL  - Germany
TA  - Eur J Cardiothorac Surg
JT  - European journal of cardio-thoracic surgery : official journal of the European 
      Association for Cardio-thoracic Surgery
JID - 8804069
SB  - IM
MH  - *Catheterization, Peripheral/adverse effects
MH  - *Extracorporeal Membrane Oxygenation/adverse effects
MH  - Female
MH  - Femoral Artery/surgery
MH  - Groin/surgery
MH  - Humans
MH  - *Lung Transplantation
MH  - Retrospective Studies
MH  - *Wound Infection
OTO - NOTNLM
OT  - Arterial complications
OT  - Extracorporeal membrane oxygenation
OT  - Lung transplantation
OT  - Percutaneous arterial closure
EDAT- 2020/02/23 06:00
MHDA- 2021/06/22 06:00
CRDT- 2020/02/22 06:00
PHST- 2019/09/09 00:00 [received]
PHST- 2020/01/14 00:00 [revised]
PHST- 2020/01/17 00:00 [accepted]
PHST- 2020/02/23 06:00 [pubmed]
PHST- 2021/06/22 06:00 [medline]
PHST- 2020/02/22 06:00 [entrez]
AID - 5743448 [pii]
AID - 10.1093/ejcts/ezaa039 [doi]
PST - ppublish
SO  - Eur J Cardiothorac Surg. 2020 Aug 1;58(2):371-378. doi: 10.1093/ejcts/ezaa039.