PMID- 36793669
OWN - NLM
STAT- MEDLINE
DCOM- 20230217
LR  - 20230217
IS  - 1540-8183 (Electronic)
IS  - 0896-4327 (Print)
IS  - 0896-4327 (Linking)
VI  - 2023
DP  - 2023
TI  - Prophylactic ECMO Support during Elective Coronary Percutaneous Interventions in 
      High-Risk Patients: A Single-Center Experience.
PG  - 5332038
LID - 10.1155/2023/5332038 [doi]
LID - 5332038
AB  - INTRODUCTION: Evidence regarding the impact of prophylactic implantation of 
      venoarterial extracorporeal membrane oxygenation (VA-ECMO) for elective high-risk 
      percutaneous coronary intervention (PCI) is limited. The purpose of this paper is 
      to evaluate the outcome during index hospitalization and 3 years after 
      interventions. METHODS: This is an observational retrospective study including 
      all patients undergoing elective, high-risk PCI and receiving VA-ECMO for 
      cardiopulmonary support. Primary endpoints were in-hospital and 3- year major 
      adverse cardiovascular and cerebrovascular event (MACCE) rates. Secondary 
      endpoints were vascular complications, bleeding, and procedural success. RESULTS: 
      Nine patients were included in total. All patients were considered inoperable by 
      the local heart team, and 1 patient had a previous coronary artery bypass graft 
      (CABG). All patients were hospitalized for an acute heart failure episode 30 days 
      before the index procedure. Severe left ventricular dysfunction was present in 8 
      patients. The main target vessel was the left main coronary artery in 5 cases. 
      Complex PCI techniques were used: bifurcations with 2 stents in 8 patients, 
      rotational atherectomy was performed in 3, and coronary lithoplasty in 1 case. 
      PCI was successful in all of the patients with revascularization of all target 
      and additional lesions. Eight of the 9 patients survived for at least 30 days 
      after the procedure, and 7 patients survived for 3 years after the procedure. 
      Regarding the complication rate, 2 patients suffered from limb ischemia and were 
      treated by an antegrade perfusion, 1 patient had a femoral perforation that 
      needed surgical repair, 6 patients had a hematoma, 5 patients had a significant 
      drop in hemoglobin of more than 2 g/dl and received blood transfusions, 2 
      patients were treated for septicemia, and 2 patients needed hemodialysis. 
      CONCLUSIONS: Prophylactic use of VA-ECMO in elective patients is an acceptable 
      strategy for revascularization by high-risk coronary percutaneous interventions 
      with good long-term outcomes for patients considered inoperable when a clear 
      clinical benefit is expected. Regarding the potential risk of complications due 
      to a VA-ECMO system, the selection of candidates in our series was based on a 
      multiparameter analysis. The two main triggers in favor of prophylactic VA-ECMO 
      in our studies were the presence of a recent heart failure episode and the high 
      probability of periprocedural prolonged impairment of the coronary flow through 
      the major epicardial artery.
CI  - Copyright (c) 2023 Claudiu Ungureanu et al.
FAU - Ungureanu, Claudiu
AU  - Ungureanu C
AUID- ORCID: 0000-0002-1583-5882
AD  - Cardiovascular Department, Jolimont Hospital, La Louviere, Belgium.
FAU - Blaimont, Marc
AU  - Blaimont M
AD  - Cardiovascular Department, Jolimont Hospital, La Louviere, Belgium.
FAU - Trine, Hugues
AU  - Trine H
AD  - Intensive Care Department, Jolimont Hospital, La Louviere, Belgium.
FAU - Henin, Pierre
AU  - Henin P
AD  - Intensive Care Department, Jolimont Hospital, La Louviere, Belgium.
FAU - Courcelle, Romain
AU  - Courcelle R
AD  - Intensive Care Department, Jolimont Hospital, La Louviere, Belgium.
FAU - Laurent, Yves
AU  - Laurent Y
AD  - Intensive Care Department, Jolimont Hospital, La Louviere, Belgium.
FAU - Van Ruyssevelt, Patrick
AU  - Van Ruyssevelt P
AD  - Cardiothoracic Surgery Department, Jolimont Hospital, La Louviere, Belgium.
FAU - Lepiece, Caroline
AU  - Lepiece C
AD  - Cardiovascular Department, Jolimont Hospital, La Louviere, Belgium.
FAU - Huberlant, Vincent
AU  - Huberlant V
AD  - Intensive Care Department, Jolimont Hospital, La Louviere, Belgium.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20230204
PL  - United States
TA  - J Interv Cardiol
JT  - Journal of interventional cardiology
JID - 8907826
SB  - IM
MH  - Humans
MH  - *Percutaneous Coronary Intervention/adverse effects/methods
MH  - *Extracorporeal Membrane Oxygenation/adverse effects/methods
MH  - Retrospective Studies
MH  - Coronary Artery Bypass/methods
MH  - *Heart Failure
MH  - Treatment Outcome
PMC - PMC9922177
COIS- The authors declare that they have no conflicts of interest.
EDAT- 2023/02/17 06:00
MHDA- 2023/02/18 06:00
PMCR- 2023/02/04
CRDT- 2023/02/16 02:19
PHST- 2022/07/06 00:00 [received]
PHST- 2022/10/17 00:00 [revised]
PHST- 2022/11/25 00:00 [accepted]
PHST- 2023/02/16 02:19 [entrez]
PHST- 2023/02/17 06:00 [pubmed]
PHST- 2023/02/18 06:00 [medline]
PHST- 2023/02/04 00:00 [pmc-release]
AID - 10.1155/2023/5332038 [doi]
PST - epublish
SO  - J Interv Cardiol. 2023 Feb 4;2023:5332038. doi: 10.1155/2023/5332038. eCollection 
      2023.