Left Ventricular Unloading With Surgically Implanted Microaxial Flow Pump in Patients on Venoarterial Membrane Oxygenation

被引：0
作者：
Lanmueller, Pia [1 ,2 ,3 ,4 ,5 ]
Hinrichs, Nils [1 ,2 ,3 ,4 ]
Nersesian, Gaik [1 ,2 ,3 ,4 ]
Lewin, Daniel [1 ,2 ,3 ,4 ]
O'Brien, Ben [2 ,3 ,4 ,6 ]
Falk, Volkmar [1 ,2 ,3 ,4 ,5 ,7 ]
Potapov, Evgenij [1 ,2 ,3 ,4 ,5 ]
Starck, Christoph [1 ,2 ,3 ,4 ,5 ,8 ]
Ott, Sascha [2 ,3 ,4 ,6 ,9 ]
机构：
[1] Deutsch Herzzentrum Charite, Dept Cardiothorac & Vasc Surg, Augustenburger Pl 1, D-13353 Berlin, Germany
[2] Charite Univ Med Berlin, 2lnstitute Biometry & Clin Epidemiol, Berlin, Germany
[3] Free Univ Berlin, Berlin, Germany
[4] Humboldt Univ, Berlin, Germany
[5] DZHK German Ctr Cardiovasc Res, Partner Site Berlin, Berlin, Germany
[6] Deutsch Herzzentrum Charite, Dept Cardiac Anaesthesiol & Intens Care Med, Berlin, Germany
[7] Swiss Fed Inst Technol, Dept Hlth Sci & Technol, Translat Cardiovasc Technol, Zurich, Switzerland
[8] Steinbeis Hsch, Steinbeis Transfer Inst Kardiotech, Berlin, Germany
[9] Cleveland Clin, Outcomes Res Consortium, Dept Anesthesiol, Cleveland, OH USA
来源：
ASAIO JOURNAL | 2025年 / 71卷 / 07期
关键词：
cardiogenic shock; extracorporeal membrane oxygenation; extracorporeal life support; microaxial flow pump; survival; complication; weaning; left ventricular unloading; PROPENSITY SCORE METHODS; EXTRACORPOREAL; DISTENSION; SURVIVAL;
D O I：
10.1097/MAT.0000000000002364
中图分类号：
R318 [生物医学工程];
学科分类号：
0831 ;
摘要：
Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is applied for the treatment of cardiogenic shock. Concomitant left ventricular unloading (LVU) with a microaxial flow pump (mAFP) enables myocardial and pulmonary recovery and may overcome some of the limitations of VA-ECMO. The study included 145 cardiogenic shock patients, 89 (61.4%) of whom were treated with VA-ECMO alone (ECMO group), whereas 56 (38.6%) received LVU with a surgically implanted mAFP on top of VA-ECMO (ECMELLA group). After 2:1 propensity score matching, 30 day and 1 year survival was similar between the groups (p = 0.62 and 0.68, respectively). In the subgroup analysis, patients who received mAFP in the first 2 hours after VA-ECMO implantation had an improved 30 day (hazard ratio [HR]: 0.45 [95% confidence interval {CI}: 0.23-0.88], p = 0.02) and 1 year survival (HR: 0.52 [95% CI: 0.28-0.97], p = 0.04). The rate of limb ischemia, hemorrhage, and renal replacement therapy were comparable between the propensity score-matched cohorts. Early LVU with a surgically implanted mAFP in patients on VA-ECMO improved short-and long-term survival.
引用
收藏
页码：536 / 543
页数：8
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