title: Survival, quality of life and impact of right heart failure in patients with acute cardiogenic shock treated with ECMO.
abstract: Mechanical circulatory support is increasingly used in acute cardiogenic shock.
  
  
  
  To assess treatment strategies for cardiogenic shock.
  
  
  
  Data of 57 patients in acute intrinsic cardiogenic shock treated with ECMO were analyzed. Different subsequent strategies (weaning, VAD, transplantation) were followed.​
  
  
  
  Overall 1, 2, and 4-year survival was 36.8 ± 6.4%, 32.2 ± 6.4%, 29.8 ± 6.3%. Elevated lactate and hemorrhagic complications (all p in patients with right heart failure prior to ECMO implantation, BVAD therapy showed a trend (p=0.058) towards superior survival compared with LVAD therapy. Seven of the BVAD patients received successful transplantation, with a 1-year survival of 71%. Among survivors Short Form 36 reported significantly lower combined physical scores (p=0.004).
  
  
  
  Right heart assessment prior to ECMO implantation may be beneficial to provide tailored therapy if ECMO weaning fails. Survival after cardiogenic shock requiring ECMO seems to be associated with impaired long-term quality of life.
authors: Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353 Berlin, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Germany. Electronic address: schoenrath@dhzb.de.
authors: Felix
authors: F
authors: Schoenrath
authors: Clinic for Cardiovascular Surgery, University Heart Center, Rämistraße 100, 8091 Zurich, Switzerland.
authors: Dennis
authors: D
authors: Hoch
authors: Clinic for Cardiovascular Surgery, University Heart Center, Rämistraße 100, 8091 Zurich, Switzerland.
authors: Francesco
authors: F
authors: Maisano
authors: Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353 Berlin, Germany.
authors: Christoph T
authors: CT
authors: Starck
authors: Epidemiology, Biostatistics and Prevention Institute, Department of Biostatistics, University of Zurich, Hirschengraben 84, 8001 Zurich, Switzerland.
authors: Burkhardt
authors: B
authors: Seifert
authors: Department for Intensive Care Medicine, University Hospital Zurich, Rämistraße 100, 8091 Zurich, Switzerland.
authors: Urs
authors: U
authors: Wenger
authors: Department for Cardiology, University Heart Center, Rämistraße 100, 8091 Zurich, Switzerland.
authors: Frank
authors: F
authors: Ruschitzka
authors: Clinic for Cardiovascular Surgery, University Heart Center, Rämistraße 100, 8091 Zurich, Switzerland.
authors: Markus J
authors: MJ
authors: Wilhelm
mesh_terms: D000328:Adult; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D005260:Female; D006333:Heart Failure / Q000150:complications* / Q000401:mortality / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012770:Shock, Cardiogenic / Q000209:etiology* / Q000401:mortality / Q000523:psychology; D015996:Survival Rate / Q000639:trends; D013557:Switzerland / Q000453:epidemiology
keywords: Cardiogenic shock; Extracorporeal membrane oxygenation; Quality of life; Right heart failure; Ventricular assist device