PMID- 37063130
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230418
IS  - 2666-2736 (Electronic)
IS  - 2666-2736 (Linking)
VI  - 13
DP  - 2023 Mar
TI  - Extracorporeal membrane oxygenation and microaxial left ventricular assist device 
      in cardiogenic shock: Choosing the right mechanical circulatory support to 
      improve outcomes.
PG  - 200-213
LID - 10.1016/j.xjon.2022.12.011 [doi]
AB  - OBJECTIVE: To evaluate the outcomes of patients supported with Impella (CP/5.0) 
      or venoarterial extracorporeal membrane oxygenation (VA-ECMO) for cardiogenic 
      shock according to shock phenotype. The primary end point was 30-day survival. 
      METHODS: A retrospective study of patients supported with Impella (CP/5.0) or 
      VA-ECMO between 2010 and 2020 was performed. Patients were grouped according to 1 
      of 2 shock phenotypes: isolated left ventricular (LV) dysfunction versus 
      biventricular dysfunction or multiple organ failure (MOF). The local practice 
      favors Impella for isolated LV dysfunction and VA-ECMO for biventricular 
      dysfunction or MOF. RESULTS: Among the 75 patients included, 17 (23%) had 
      isolated LV dysfunction. Patients with biventricular dysfunction or MOF had a 
      greater median lactate level compared with those with isolated LV dysfunction 
      (7.9 [2.9-11.8] vs 3.8 [1.1-5.8] mmol/L, respectively). Among patients with 
      isolated LV dysfunction, 30-day survival was 46% for the Impella group (n = 13) 
      and 75% for VA-ECMO (n = 4). Among patients with biventricular dysfunction or 
      MOF, 30-day survival was 9% for the Impella group (n = 11) and 28% for VA-ECMO 
      (n = 47). Patients supported with Impella 5.0 had better 30-day survival compared 
      with those supported with Impella CP, for both shock phenotypes (83% vs 14% and 
      14% vs 0%, respectively). CONCLUSIONS: In this small cohort, patients supported 
      with Impella for isolated LV dysfunction and VA-ECMO for biventricular 
      dysfunction or MOF had acceptable survival at 30 days. Patients with 
      biventricular dysfunction or MOF who were supported by Impella had the lowest 
      survival rates. Patients with isolated LV dysfunction who were supported with 
      VA-ECMO had good 30-day survival.
CI  - (c) 2023 The Author(s).
FAU - Dagher, Olina
AU  - Dagher O
AD  - Department of Surgery, Montreal Heart Institute, Montreal, Quebec, Canada.
AD  - Faculty of Medicine, Universite de Montreal, Montreal, Quebec, Canada.
AD  - Department of Cardiac Sciences, Libin Cardiovascular Institute, Calgary, Alberta, 
      Canada.
FAU - Noly, Pierre-Emmanuel
AU  - Noly PE
AD  - Department of Surgery, Montreal Heart Institute, Montreal, Quebec, Canada.
FAU - Ben Ali, Walid
AU  - Ben Ali W
AD  - Department of Surgery, Montreal Heart Institute, Montreal, Quebec, Canada.
FAU - Bouabdallaoui, Nadia
AU  - Bouabdallaoui N
AD  - Universite de Montreal and Department of Cardiology, Montreal Heart Institute, 
      Montreal, Quebec, Canada.
FAU - Geicu, Lucian
AU  - Geicu L
AD  - Department of Surgery, Montreal Heart Institute, Montreal, Quebec, Canada.
FAU - Lamanna, Roxanne
AU  - Lamanna R
AD  - Faculty of Medicine, Universite de Montreal, Montreal, Quebec, Canada.
FAU - Malhi, Pavan
AU  - Malhi P
AD  - Faculty of Medicine, Universite de Montreal, Montreal, Quebec, Canada.
FAU - Romero, Elizabeth
AU  - Romero E
AD  - Faculty of Medicine, Universite de Montreal, Montreal, Quebec, Canada.
FAU - Ducharme, Anique
AU  - Ducharme A
AD  - Faculty of Medicine, Universite de Montreal, Montreal, Quebec, Canada.
AD  - Universite de Montreal and Department of Cardiology, Montreal Heart Institute, 
      Montreal, Quebec, Canada.
FAU - Demers, Philippe
AU  - Demers P
AD  - Department of Surgery, Montreal Heart Institute, Montreal, Quebec, Canada.
FAU - Lamarche, Yoan
AU  - Lamarche Y
AD  - Department of Surgery, Montreal Heart Institute, Montreal, Quebec, Canada.
LA  - eng
PT  - Journal Article
DEP - 20230116
PL  - Netherlands
TA  - JTCVS Open
JT  - JTCVS open
JID - 101768541
PMC - PMC10091281
OTO - NOTNLM
OT  - Impella
OT  - VA-ECMO
OT  - cardiogenic shock
OT  - mechanical circulatory support
EDAT- 2023/04/18 06:00
MHDA- 2023/04/18 06:01
PMCR- 2023/01/16
CRDT- 2023/04/17 03:25
PHST- 2022/05/18 00:00 [received]
PHST- 2022/11/11 00:00 [revised]
PHST- 2022/12/05 00:00 [accepted]
PHST- 2023/04/18 06:01 [medline]
PHST- 2023/04/17 03:25 [entrez]
PHST- 2023/04/18 06:00 [pubmed]
PHST- 2023/01/16 00:00 [pmc-release]
AID - S2666-2736(23)00009-8 [pii]
AID - 10.1016/j.xjon.2022.12.011 [doi]
PST - epublish
SO  - JTCVS Open. 2023 Jan 16;13:200-213. doi: 10.1016/j.xjon.2022.12.011. eCollection 
      2023 Mar.