title: Central extracorporeal life support with left ventricular decompression for the treatment of refractory cardiogenic shock and lung failure.
abstract: BACKGROUND
  The purpose of this prospective study was to evaluate the effects and functional outcome of central extracorporeal life support (ECLS) with left ventricular decompression for the treatment of refractory cardiogenic shock and lung failure.
  
  
  METHODS
  Between August 2010 and August 2013, 12 consecutive patients (2 female) with a mean age of 31.6 ± 15.1 years received central ECLS with left ventricular decompression for the treatment of refractory cardiogenic shock and lung failure. Underlying disease was acute cardiac decompensation due to dilated cardiomyopathy (n = 3, 25%), coronary artery disease with acute myocardial infarction (AMI) (n = 3, 25%), and acute myocarditis (n = 6, 50%). We routinely implemented ECLS by cannulating the ascending aorta, right atrium and inserting a left ventricular decompression cannula vent via the right superior pulmonary vein.
  
  
  RESULTS
  All patients were successfully bridged to either recovery (n = 3, 25%), long-term biventricular support (n = 6, 50%) or cardiac transplantation (n = 3, 25%). Seven patients (58.3%) were discharged after a mean hospital stay of 42 ± 11.9 days. The overall survival from ECLS implantation to the end of the study was 58.3%. The cumulative ICU stay was 23.1 ± 9.6 days. The length of support was 8.0 ± 4.3 days (range 3-17 days).
  
  
  CONCLUSIONS
  We strongly recommend left ventricular decompression in refractory cardiogenic shock and lung failure to avoid pulmonary edema, left heart distension and facilitate myocardial recovery.
authors.affiliation: Department of Cardiothoracic Transplantation & Mechanical Circulatory Support, Royal Brompton and Harefield NHS Foundation Trust, Hill End Road, Harefield, Middlesex, UB9 6JH London, UK. weymann.alexander@googlemail.com.
authors.forename: Alexander
authors.initials: A
authors.lastname: Weymann
authors.forename: Bastian
authors.initials: B
authors.lastname: Schmack
authors.forename: Anton
authors.initials: A
authors.lastname: Sabashnikov
authors.forename: Christopher T
authors.initials: CT
authors.lastname: Bowles
authors.forename: Philipp
authors.initials: P
authors.lastname: Raake
authors.forename: Rawa
authors.initials: R
authors.lastname: Arif
authors.forename: Markus
authors.initials: M
authors.lastname: Verch
authors.forename: Ursula
authors.initials: U
authors.lastname: Tochtermann
authors.forename: Jens
authors.initials: J
authors.lastname: Roggenbach
authors.forename: Aron Frederik
authors.initials: AF
authors.lastname: Popov
authors.forename: Andre Ruediger
authors.initials: AR
authors.lastname: Simon
authors.forename: Matthias
authors.initials: M
authors.lastname: Karck
authors.forename: Arjang
authors.initials: A
authors.lastname: Ruhparwar
mesh_terms: D000293:Adolescent; D000328:Adult; D001663:Bilirubin / Q000097:blood; D003404:Creatinine / Q000097:blood; D019299:Decompression, Surgical / Q000379:methods*; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D005260:Female; D006352:Heart Ventricles / Q000601:surgery*; D006801:Humans; D008168:Lung / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012770:Shock, Cardiogenic / Q000097:blood / Q000503:physiopathology / Q000601:surgery*; D055815:Young Adult
chemical_list: D003404:Creatinine; D001663:Bilirubin