PMID- 32728712 OWN - NLM STAT- MEDLINE DCOM- 20210419 LR - 20210419 IS - 1569-9285 (Electronic) IS - 1569-9285 (Linking) VI - 31 IP - 3 DP - 2020 Sep 1 TI - The use of extracorporeal membrane oxygenation in the setting of postinfarction mechanical complications: outcome analysis of the Extracorporeal Life Support Organization Registry. PG - 369-374 LID - 10.1093/icvts/ivaa108 [doi] AB - 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 (>18 years 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 62.4 years (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 5.9 days (range 1 h-40.3 days). 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. 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 - Matteucci, Matteo AU - Matteucci M AD - Department of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, Netherlands. AD - Department of Cardiac Surgery, Circolo Hospital, University of Insubria, Varese, Italy. FAU - Fina, Dario AU - Fina D AD - Department of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, Netherlands. AD - Department of Intensive Care Unit, IRCCS Policlinico San Donato, University of Milan, Milan, Italy. FAU - Jiritano, Federica AU - Jiritano F AD - Department of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, Netherlands. AD - Department of Cardiac Surgery, University Magna Graecia of Catanzaro, Catanzaro, Italy. FAU - Meani, Paolo AU - Meani P AD - Department of Cardiology, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, Netherlands. FAU - Raffa, Giuseppe Maria AU - Raffa GM AD - Department of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, Netherlands. AD - Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS-ISMETT (Instituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione), Palermo, Italy. FAU - Kowalewski, Mariusz AU - Kowalewski M AD - Department of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, Netherlands. AD - Clinical Department of Cardiac Surgery, Central Clinical Hospital of the Ministry of Interior in Warsaw, Warsaw, Poland. FAU - Aldobayyan, Ibrahim AU - Aldobayyan I AD - Department of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, Netherlands. FAU - Turkistani, Mohammad AU - Turkistani M AD - Department of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, Netherlands. FAU - Beghi, Cesare AU - Beghi C AD - Department of Cardiac Surgery, Circolo Hospital, University of Insubria, Varese, Italy. FAU - Lorusso, Roberto AU - Lorusso R AD - Department of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, Netherlands. AD - Department of Intensive Care Unit, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, Netherlands. LA - eng PT - Journal Article PT - Multicenter Study PL - England TA - Interact Cardiovasc Thorac Surg JT - Interactive cardiovascular and thoracic surgery JID - 101158399 SB - IM MH - Adult MH - Aged MH - Aged, 80 and over MH - Extracorporeal Membrane Oxygenation/*statistics & numerical data MH - Female MH - Global Health MH - Hospital Mortality/trends MH - Humans MH - Male MH - Middle Aged MH - Myocardial Infarction/*complications MH - *Registries MH - Retrospective Studies MH - Shock, Cardiogenic/etiology/mortality/*therapy MH - Survival Rate/trends MH - Treatment Outcome MH - Young Adult OTO - NOTNLM OT - Acute myocardial infarction OT - Cardiac arrest OT - Cardiogenic shock OT - Extracorporeal membrane oxygenation OT - Mechanical complications EDAT- 2020/07/31 06:00 MHDA- 2021/04/20 06:00 CRDT- 2020/07/31 06:00 PHST- 2020/02/25 00:00 [received] PHST- 2020/04/24 00:00 [revised] PHST- 2020/05/18 00:00 [accepted] PHST- 2020/07/31 06:00 [pubmed] PHST- 2021/04/20 06:00 [medline] PHST- 2020/07/31 06:00 [entrez] AID - 5878172 [pii] AID - 10.1093/icvts/ivaa108 [doi] PST - ppublish SO - Interact Cardiovasc Thorac Surg. 2020 Sep 1;31(3):369-374. doi: 10.1093/icvts/ivaa108.