title: Percutaneous Venoarterial Extracorporeal Membrane Oxygenation for Refractory Cardiogenic Shock Is Associated with Improved Short- and Long-Term Survival.
abstract: Mortality due to refractory cardiogenic shock (RCS) exceeds 50%. Venoarterial extracorporeal membrane oxygenation (VA-ECMO) has become an accepted therapy for RCS. The aim of our study was to evaluate outcomes of patients with RCS treated with percutaneous VA-ECMO (pVA-ECMO). Retrospective review of patients supported with VA-ECMO at our institution in 2012-2013. Clinical characteristics, bleeding, vascular complications, and outcomes including survival were assessed. A total of 37 patients were supported with VA-ECMO for RCS. The majority of VA-ECMO (76%) was placed in the catheterization laboratory. Nearly half (49%) of the patients presented with acute myocardial infarction. Seven patients (19%) underwent insertion of pVA-ECMO in the setting of cardiopulmonary resuscitation with mechanical chest compression device. Median duration of support was 5 days. Index hospitalization, 30-day, and 1-year survival were 65%, 65%, and 57%, respectively. Survival rate for discharged patients was 87.5% with a median follow-up of 450 days. Refractory cardiogenic shock supported with pVA-ECMO is associated with an improved survival in patients with a traditionally poor prognosis.
authors.affiliation: From the *Minneapolis Heart Institute, Abbott Northwestern Hospital, Minneapolis, Minnesota; †Division of Cardiology, Department of Medicine, Hennepin County Medical Center, Minneapolis, Minnesota; ‡Department of Intensive Care Medicine at Abbott Northwestern Hospital, Minneapolis, Minnesota; and §Minneapolis Heart Institute Foundation, Minneapolis, Minnesota.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Hryniewicz
authors.forename: Yader
authors.initials: Y
authors.lastname: Sandoval
authors.forename: Michael
authors.initials: M
authors.lastname: Samara
authors.forename: Mosi
authors.initials: M
authors.lastname: Bennett
authors.forename: Barry
authors.initials: B
authors.lastname: Cabuay
authors.forename: Ivan J
authors.initials: IJ
authors.lastname: Chavez
authors.forename: Susan
authors.initials: S
authors.lastname: Seatter
authors.forename: Peter
authors.initials: P
authors.lastname: Eckman
authors.forename: Peter
authors.initials: P
authors.lastname: Zimbwa
authors.forename: Aaron
authors.initials: A
authors.lastname: Dunn
authors.forename: Benjamin
authors.initials: B
authors.lastname: Sun
mesh_terms: D000328:Adult; D000368:Aged; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010314:Partial Thromboplastin Time; D012189:Retrospective Studies; D012770:Shock, Cardiogenic / Q000401:mortality / Q000628:therapy*