title: Better outcome after cardiopulmonary resuscitation using percutaneous emergency circulatory support in non-coronary patients compared to those with myocardial infarction.
abstract: OBJECTIVE
  Mobile heart-lung-machines applied by percutaneous cannulation are mostly used in patients suffering from acute myocardial infarction (AMI). Whether patients with non-coronary reasons for circulatory arrest benefit of percutaneous emergency circulatory support (PECS) in the same way is still unclear.
  
  
  METHODS
  We included 22 consecutive patients who were treated by PECS during a registry period of two years. Primary study endpoint was 30-day mortality rate.
  
  
  RESULTS
  Circulatory arrest was caused by AMI in 14 patients (64%). The remaining 8 patients suffered from cardiomyopathy/myocarditis, 4; pulmonary embolism, 2; acute pulmonary failure, 1; and tumor lysis syndrome, 1. Revascularization rate was 93% in the AMI group under PECS support. Overall survival rate was 36.4% at one month: it reached 62.5% among non-coronary patients, but only 21.4% in the AMI group (P = 0.02). Weaning was possible by direct heart transplantation in two patients. Additional two patients required implantation of a left ventricular assist device. Pumpless extracorporeal lung assist was used in one case.
  
  
  CONCLUSIONS
  In this small retrospective study percutaneous emergency circulatory support provided sufficient hemodynamic stabilization in emergency situations. One fifth of AMI patients were saved by immediate restoration of circulation and causal treatment when other means of resuscitation failed. Higher survival rates were noted in non-coronary patients.
authors.affiliation: Friedrich-Schiller-University, Clinic of Internal Medicine, Jena, Germany. markus.ferrari@med.uni-jena.de
authors.forename: Markus
authors.initials: M
authors.lastname: Ferrari
authors.forename: Khosro
authors.initials: K
authors.lastname: Hekmat
authors.forename: Christian
authors.initials: C
authors.lastname: Jung
authors.forename: Katharina
authors.initials: K
authors.lastname: Ferrari-Kuehne
authors.forename: Ruediger
authors.initials: R
authors.lastname: Pfeifer
authors.forename: Markus H
authors.initials: MH
authors.lastname: Schlosser
authors.forename: Gerald S
authors.initials: GS
authors.lastname: Werner
authors.forename: Hans R
authors.initials: HR
authors.lastname: Figulla
mesh_terms: D016887:Cardiopulmonary Resuscitation; D002404:Catheterization; D004632:Emergency Medical Services; D005260:Female; D006323:Heart Arrest / Q000401:mortality / Q000628:therapy*; D006355:Heart-Lung Machine; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000628:therapy*; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome