Outcome of extracorporeal membrane oxygenation support for complex high-risk elective percutaneous coronary interventions: A single-center experience.
OBJECTIVE
We report our initial experience with extracorporeal membrane oxygenation (ECMO) use in elective high-risk complex percutaneous coronary intervention (PCI).


BACKGROUND
ECMO has been employed as hemodynamic support in patients with cardiac arrest and hemodynamic shock.


METHODS
We performed a single-center prospectical study, enrolling all patients at very high-risk for coronary artery bypass grafting (CABG). Major adverse cardiac and cerebrovascular events (MACCE) were defined as a composite of death, acute myocardial infarction (MI), stroke and further need for revascularization.


RESULTS
Twelve patients underwent elective high-risk PCI with ECMO support (mean age = 63.5 ± 8.7 years). The mean SYNTAX score was 30.1 ± 10.1. All PCI procedures were successful and no in-hospital MACCE was observed. At 6-months, neither death nor MI was noticed. Two patients (17%) required further revascularization, and one patient required chronic hemodialysis.


CONCLUSIONS
Elective high-risk PCI supported by ECMO is a viable alternative for patients who are at very high risk for CABG.
Department of Medical Sciences and Pediatrics, Catheterization Laboratory and Cardiovascular Interventional Unit, Cannizzaro Hospital, University of Catania, Via Messina 829, 95126 Catania, Italy.
Salvatore Davide
SD
Tomasello
Department of Medical Sciences and Pediatrics, Catheterization Laboratory and Cardiovascular Interventional Unit, Cannizzaro Hospital, University of Catania, Via Messina 829, 95126 Catania, Italy; Faculty of Medicine of Tunis, University Tunis El Manar, Tunisia.
Marouane
M
Boukhris
Department of Interventional Cardiology, State Research Institute for Complex Issues of Cardiovascular Diseases, Siberian Branch of the Russian Academy of Medical Sciences, 6 Sosnovy Boulevard, Kemerovo 650002, Russia. Electronic address: ganyukov@mail.ru.
Vladimir
V
Ganyukov
Department of Medical Sciences and Pediatrics, Catheterization Laboratory and Cardiovascular Interventional Unit, Cannizzaro Hospital, University of Catania, Via Messina 829, 95126 Catania, Italy.
Alfredo R
AR
Galassi
Department of Medical Sciences and Pediatrics, Catheterization Laboratory and Cardiovascular Interventional Unit, Cannizzaro Hospital, University of Catania, Via Messina 829, 95126 Catania, Italy.
Dmitri
D
Shukevich
Department of Interventional Cardiology, State Research Institute for Complex Issues of Cardiovascular Diseases, Siberian Branch of the Russian Academy of Medical Sciences, 6 Sosnovy Boulevard, Kemerovo 650002, Russia.
Boris
B
Haes
Department of Interventional Cardiology, State Research Institute for Complex Issues of Cardiovascular Diseases, Siberian Branch of the Russian Academy of Medical Sciences, 6 Sosnovy Boulevard, Kemerovo 650002, Russia.
Nikita
N
Kochergin
Department of Interventional Cardiology, State Research Institute for Complex Issues of Cardiovascular Diseases, Siberian Branch of the Russian Academy of Medical Sciences, 6 Sosnovy Boulevard, Kemerovo 650002, Russia.
Roman
R
Tarasov
Department of Interventional Cardiology, State Research Institute for Complex Issues of Cardiovascular Diseases, Siberian Branch of the Russian Academy of Medical Sciences, 6 Sosnovy Boulevard, Kemerovo 650002, Russia.
Vadim
V
Popov
Department of Interventional Cardiology, State Research Institute for Complex Issues of Cardiovascular Diseases, Siberian Branch of the Russian Academy of Medical Sciences, 6 Sosnovy Boulevard, Kemerovo 650002, Russia.
Leonid
L
Barbarash
D000368:Aged; D001026:Coronary Artery Bypass / Q000379:methods; D003324:Coronary Artery Disease / Q000601:surgery*; D017558:Elective Surgical Procedures / Q000379:methods; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D005260:Female; D006323:Heart Arrest / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000601:surgery; D009204:Myocardial Revascularization / Q000379:methods; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D011446:Prospective Studies; D012086:Reoperation; D012307:Risk Factors; D020521:Stroke / Q000209:etiology; D016896:Treatment Outcome
Complex PCI; Extracorporeal membrane oxygenation support; High risk CABG; High-risk elective PCI; Left ventricular assistance device