PMID- 33313742
OWN - NLM
STAT- MEDLINE
DCOM- 20210701
LR  - 20210701
IS  - 1873-734X (Electronic)
IS  - 1010-7940 (Linking)
VI  - 59
IP  - 3
DP  - 2021 Apr 13
TI  - Right axillary artery cannulation for venoarterial extracorporeal membrane 
      oxygenation: a retrospective single centre observational study.
PG  - 601-609
LID - 10.1093/ejcts/ezaa397 [doi]
AB  - OBJECTIVES: Our goal was to assess the safety, outcomes and complication rate of 
      axillary artery cannulation for venoarterial extracorporeal membrane oxygenation 
      (VA-ECMO). METHODS: A retrospective analysis was conducted on data obtained from 
      the review of medical charts of all consecutive patients undergoing VA-ECMO 
      implantation between January 2013 and December 2017 at a teaching hospital. Only 
      patients with right axillary VA-ECMO implantation in a non-emergency setting were 
      included. Post-procedural outcomes and local and systemic complications were 
      analysed. RESULTS: One hundred and seventy-four [131 male (75.3%), 43 female 
      (24.7%); mean age 56.8 +/- 15.1 years] patients underwent femoral-axillary VA-ECMO. 
      Indications were cardiogenic shock from any cause (n = 78, 44.8%) or 
      post-cardiotomy syndrome (n = 96, 55.2%). Fifty-three (30.5%) patients died while 
      on VA-ECMO support. At the time of VA-ECMO ablation, 89 (51.1%) patients had 
      recovered; 13 (7.5%) patients were bridged to a long-term mechanical support 
      device and 19 (10.9%) patients underwent heart transplants. Thirty-day and 1-year 
      mortality was 36.2% (n = 63) and 49.4% (n = 86), respectively. The 1-year 
      survival rate of patients who were weaned from VA-ECMO support was 72.7% 
      (n = 88). The complications of axillary cannulation were bleeding (n = 7, 4%), 
      local infection (n = 3, 1.7%), upper limb ischaemia (n = 2, 1.1%) and brachial 
      plexus injury (n = 1, 0.6%). Left ventricle unloading was required for 9 (5.2%) 
      patients. The median duration of VA-ECMO support was 7 (range 1-26) days. 
      CONCLUSIONS: Right axillary artery cannulation is a safe and reliable method for 
      VA-ECMO support with a low rate of local complications. In the absence of a 
      control group with femoro-femoral cannulation, no definitive conclusion about the 
      superiority of axillary over femoral cannulation can be drawn.
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 - Pisani, Angelo
AU  - Pisani A
AD  - Department of Cardiovascular Surgery, Universite de Paris, Bichat-Claude Bernard 
      Hospital, Paris, France.
FAU - Braham, Wael
AU  - Braham W
AD  - Department of Cardiovascular Surgery, Universite de Paris, Bichat-Claude Bernard 
      Hospital, Paris, France.
FAU - Brega, Carlotta
AU  - Brega C
AD  - Department of Cardiovascular Surgery, Universite de Paris, Bichat-Claude Bernard 
      Hospital, Paris, France.
AD  - Maria Cecilia Hospital, GVM Care and Research, Cotignola, Ravenna, Italy.
FAU - Lajmi, Moklhes
AU  - Lajmi M
AD  - Department of Cardiovascular Surgery, Universite de Paris, Bichat-Claude Bernard 
      Hospital, Paris, France.
FAU - Provenchere, Sophie
AU  - Provenchere S
AD  - Department of Anesthesia, Universite de Paris, Bichat-Claude Bernard Hospital, 
      Paris, France.
AD  - Universite de Paris, Centre d'Investigation Clinique 1425, INSERM, Paris, France.
FAU - Danial, Pichoy
AU  - Danial P
AD  - Department of Cardiovascular Surgery, Universite de Paris, Bichat-Claude Bernard 
      Hospital, Paris, France.
FAU - Alkhoder, Soleiman
AU  - Alkhoder S
AD  - Department of Cardiovascular Surgery, Universite de Paris, Bichat-Claude Bernard 
      Hospital, Paris, France.
FAU - Para, Marylou
AU  - Para M
AD  - Department of Cardiovascular Surgery, Universite de Paris, Bichat-Claude Bernard 
      Hospital, Paris, France.
AD  - Universite de Paris, LVTS UMRS 1148, INSERM, Paris, France.
FAU - Ghodbane, Walid
AU  - Ghodbane W
AD  - Department of Cardiovascular Surgery, Universite de Paris, Bichat-Claude Bernard 
      Hospital, Paris, France.
FAU - Nataf, Patrick
AU  - Nataf P
AD  - Department of Cardiovascular Surgery, Universite de Paris, Bichat-Claude Bernard 
      Hospital, Paris, France.
LA  - eng
PT  - Journal Article
PT  - Observational Study
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  - Adult
MH  - Aged
MH  - Axillary Artery/surgery
MH  - Catheterization
MH  - *Extracorporeal Membrane Oxygenation/adverse effects
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Shock, Cardiogenic/therapy
OTO - NOTNLM
OT  - Cardiovascular surgery
OT  - Heart failure
OT  - Mechanical support
OT  - Venoarterial extracorporeal membrane oxygenation
EDAT- 2020/12/15 06:00
MHDA- 2021/07/02 06:00
CRDT- 2020/12/14 11:02
PHST- 2020/05/13 00:00 [received]
PHST- 2020/09/03 00:00 [revised]
PHST- 2020/09/11 00:00 [accepted]
PHST- 2020/12/15 06:00 [pubmed]
PHST- 2021/07/02 06:00 [medline]
PHST- 2020/12/14 11:02 [entrez]
AID - 6032816 [pii]
AID - 10.1093/ejcts/ezaa397 [doi]
PST - ppublish
SO  - Eur J Cardiothorac Surg. 2021 Apr 13;59(3):601-609. doi: 10.1093/ejcts/ezaa397.