PMID- 32997787
OWN - NLM
STAT- MEDLINE
DCOM- 20210728
LR  - 20210919
IS  - 1526-6702 (Electronic)
IS  - 0730-2347 (Print)
IS  - 0730-2347 (Linking)
VI  - 47
IP  - 3
DP  - 2020 Jun 1
TI  - Mechanical Circulatory Support to Treat Pulmonary Embolism: Venoarterial 
      Extracorporeal Membrane Oxygenation and Right Ventricular Assist Devices.
PG  - 202-206
LID - 10.14503/THIJ-19-7025 [doi]
AB  - Mechanical circulatory support may help patients with massive pulmonary embolism 
      who are not candidates for systemic thrombolysis, pulmonary embolectomy, or 
      catheter-directed therapy, or in whom these established interventions have 
      failed. Little published literature covers this topic, which led us to compare 
      outcomes of patients whose massive pulmonary embolism was managed with the use of 
      venoarterial extracorporeal membrane oxygenation (VA-ECMO) or a right ventricular 
      assist device (RVAD). We searched the medical literature from January 1990 
      through September 2018 for reports of adults hospitalized for massive or 
      high-risk pulmonary embolism complicated by hemodynamic instability, and who 
      underwent VA-ECMO therapy or RVAD placement. Primary outcomes included weaning 
      from mechanical circulatory support and discharge from the hospital. We found 16 
      reports that included 181 patients (164 VA-ECMO and 17 RVAD). All RVAD recipients 
      were successfully weaned from support, as were 122 (74%) of the VA-ECMO patients. 
      Sixteen (94%) of the RVAD patients were discharged from the hospital, as were 120 
      (73%) of the VA-ECMO patients. Of note, the 8 RVAD patients who had an Impella RP 
      System were all weaned and discharged. For patients with massive pulmonary 
      embolism who are not candidates for conventional interventions or whose 
      conditions are refractory, mechanical circulatory support in the form of RVAD 
      placement or ECMO may be considered. Larger comparative studies are needed.
CI  - (c) 2020 by the Texas Heart(R) Institute, Houston.
FAU - Bhalla, Aneil
AU  - Bhalla A
AD  - Section of Cardiovascular Medicine, Yale University School of Medicine, Yale New 
      Haven Hospital, New Haven, Connecticut 06519.
FAU - Attaran, Robert
AU  - Attaran R
AD  - Section of Cardiovascular Medicine, Yale University School of Medicine, Yale New 
      Haven Hospital, New Haven, Connecticut 06519.
LA  - eng
GR  - UL1 TR001863/TR/NCATS NIH HHS/United States
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Tex Heart Inst J
JT  - Texas Heart Institute journal
JID - 8214622
SB  - IM
MH  - Extracorporeal Membrane Oxygenation/*methods
MH  - Heart Ventricles
MH  - *Heart-Assist Devices
MH  - Humans
MH  - Pulmonary Embolism/*therapy
PMC - PMC7529065
OTO - NOTNLM
OT  - Contraindications
OT  - extracorporeal membrane oxygenation
OT  - heart-assist devices
OT  - pulmonary embolism/complications/prevention & control/therapy
OT  - retrospective studies
OT  - treatment outcome
OT  - ventricular dysfunction, right/therapy
EDAT- 2020/10/01 06:00
MHDA- 2021/07/29 06:00
PMCR- 2020/06/01
CRDT- 2020/09/30 17:12
PHST- 2020/09/30 17:12 [entrez]
PHST- 2020/10/01 06:00 [pubmed]
PHST- 2021/07/29 06:00 [medline]
PHST- 2020/06/01 00:00 [pmc-release]
AID - 444101 [pii]
AID - 10.14503/THIJ-19-7025 [doi]
PST - ppublish
SO  - Tex Heart Inst J. 2020 Jun 1;47(3):202-206. doi: 10.14503/THIJ-19-7025.