scholarly journals Surgical outcomes in cardiogenic shock patients with preoperative extracorporeal membrane oxygenation (ECMO)

2021 ◽  
Author(s):  
Mahmoud Yousef Ibrahim Abuharb ◽  
Dong Ran ◽  
Zheng Jubing
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Extracorporeal Membrane Oxygenation ◽  
Cardiogenic Shock ◽  
Coronary Artery Bypass ◽  
Surgical Outcomes ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Membrane Oxygenation

Abstract Objectives To summarise the surgical outcomes in patients with cardiogenic shock supported by preoperative extracorporeal membrane oxygenation (ECMO). Methods Between May 2012 and August 2017, eight patients with cardiogenic shock, who were supported by ECMO, underwent emergency surgery; four of them had isolated coronary artery bypass grafting, three had coronary artery bypass grafting with mitral replacement, and one had mitral valve replacement with left ventricular posterior wall repair. Results All eight patients were successfully weaned off from ECMO after their surgeries. Postoperative ECMO time ranged from 6.8 to 228.0 hours, with a median of 68.4 hours. Two patients died postoperatively while another six survived. The follow up time for the six patients ranged from three to 66 months, whereby one of them died in the third month due to septicaemia. The remaining five patients survived with good cardiac function based on the NYHA classification. Conclusion ECMO is a vital bridge in the preparation of critically-ill patients for cardiac surgery. It is associated with acceptable outcomes among most of the patients.

scholarly journals Surgical outcomes in cardiogenic shock patients with preoperative extracorporeal membrane oxygenation (ECMO)

2021 ◽  
Author(s):  
Mahmoud Yousef Ibrahim Abuharb ◽  
Dong Ran ◽  
Zheng Jubing
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Extracorporeal Membrane Oxygenation ◽  
Cardiogenic Shock ◽  
Coronary Artery Bypass ◽  
Surgical Outcomes ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Membrane Oxygenation

Abstract Objectives To summarise the surgical outcomes in patients with cardiogenic shock supported by preoperative extracorporeal membrane oxygenation (ECMO). Methods Between May 2012 and August 2017, eight patients with cardiogenic shock patients supported by ECMO underwent emergency surgery; four of them had isolated coronary artery bypass grafting, three had coronary artery bypass grafting with mitral replacement, and one had mitral valve replacement with left ventricular posterior wall repair. Results All eight patients successfully weaned off from ECMO after their surgeries. Postoperative ECOM time ranged from 6.8 to 228 hours, with a median of 68.4 hours. Two patients died postoperatively while another six survived. The follow up time for the six patients was ranged from three to 66 months whereby one of them died in the third month due to septicaemia. The remaining five patients survived with good cardiac function based on the NYHA classification. Conclusion ECMO is a vital bridge in the preparation of critically-ill patients for cardiac surgery. It is associated with acceptable outcomes among the majority of the patients.

scholarly journals Surgical outcomes in cardiogenic shock patients with preoperative extracorporeal membrane oxygenation (ECMO)

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Mahmoud Yousef Ibrahim Abuharb ◽  
Dong Ran ◽  
Zheng Jubing ◽  
Liu Taoshuai ◽  
Dong Haiming ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Extracorporeal Membrane Oxygenation ◽  
Cardiogenic Shock ◽  
Coronary Artery Bypass ◽  
Surgical Outcomes ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Membrane Oxygenation

Abstract Objectives To summarise the surgical outcomes in patients with cardiogenic shock supported by preoperative extracorporeal membrane oxygenation (ECMO). Methods Between May 2012 and August 2017, eight patients with cardiogenic shock, who were supported by ECMO, underwent emergency surgery; four of them had isolated coronary artery bypass grafting, three had coronary artery bypass grafting with mitral replacement, and one had mitral valve replacement with left ventricular posterior wall repair. Results All eight patients were successfully weaned off from ECMO after their surgeries. Postoperative ECMO time ranged from 6.8 to 228.0 h, with a median of 68.4 h. Two patients died postoperatively while another six survived. The follow up time for the six patients ranged from three to 66 months, whereby one of them died in the third month due to septicaemia. The remaining five patients survived with good cardiac function based on the NYHA classification. Conclusion ECMO is a vital bridge in the preparation of critically-ill patients for cardiac surgery. It is associated with acceptable outcomes among most of the patients.

Predictors for unsuccessful weaning from venoarterial extracorporeal membrane oxygenation in patients undergoing coronary artery bypass grafting

Perfusion ◽  
2020 ◽  
Vol 35 (7) ◽  
pp. 598-607
Author(s):  
Juanjuan Shao ◽  
Liangshan Wang ◽  
Hong Wang ◽  
Xiaotong Hou
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Confidence Interval ◽  
Extracorporeal Membrane Oxygenation ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Membrane Oxygenation ◽  
Venoarterial Extracorporeal Membrane Oxygenation

Background: Studies reporting risk factors associated with unsuccessful weaning for coronary artery bypass grafting patients on venoarterial extracorporeal membrane oxygenation are scarce. This study was designed to identify factors associated with unsuccessful weaning from venoarterial extracorporeal membrane oxygenation. Methods: Data from 166 coronary artery bypass grafting patients supported with venoarterial extracorporeal membrane oxygenation at the Beijing Anzhen Hospital between February 2004 and March 2017 were retrospectively analyzed. Multivariable logistic regression was performed using bootstrapping methodology to identify factors independently associated with unsuccessful weaning from venoarterial extracorporeal membrane oxygenation. Results: A total of 106 patients (64%) could be weaned from venoarterial extracorporeal membrane oxygenation, and 74 patients (45%) were alive at hospital discharge. The 30-day and 60-day survival rates after ECMO weaning were 72% and 70%, respectively. Pre-existing hypertension (odds ratio, 2.54; 95% confidence interval, 1.16-5.56; p = 0.02), serum creatinine (+1 μmol/L; odds ratio, 1.008; 95% confidence interval, 1.003-1.013; p = 0.001), and serum lactate (+1 mmol/L; odds ratio, 1.17; 95% confidence interval, 1.08-1.26; p = 0.001) were independent risk factors associated with unsuccessful weaning from venoarterial extracorporeal membrane oxygenation. Higher platelet count was protective (+1 × 109/L; odds ratio, 0.992; 95% confidence interval, 0.986-0.998; p = 0.011). The area under the receiver operating characteristic curve 0.81 (95% confidence interval, 0.75-0.88) for the logistic regression model was better than those for the survival after VA-ECMO score (p = 0.002), EuroSCORE (p < 0.001), and the prEdictioN of Cardiogenic shock OUtcome foR Acute myocardial infarction patients salvaGed by VA-ECMO scores (p = 0.02) in this population. The pRedicting mortality in patients undergoing venoarterial Extracorporeal MEMBrane oxygenation after coronary artEry bypass gRafting (0.76; 95% confidence interval, 0.68-0.83; p = 0.29) and sepsis-related organ failure assessment score (0.77; 95% confidence interval, 0.70-0.85; p = 0.46) exhibited good performances similar to the logistic regression model. Conclusion: Pre-existing hypertension, serum creatinine, serum lactate, and low platelet count were independent predictors for unsuccessful weaning from venoarterial extracorporeal membrane oxygenation in patients undergoing coronary artery bypass grafting.

Abstract 16253: Temporal Trends and Outcomes of Coronary Artery Bypass Grafting After Acute St-elevation Myocardial Infarction

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Ayman Elbadawi ◽  
Mohammed Elzeneini ◽  
Islam Y Elgendy ◽  
Mohamed Omer ◽  
Gbolahan O Ogunbayo ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Blood Transfusion ◽  
Hospital Mortality ◽  
Cardiogenic Shock ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Artery Bypass Grafting

Introduction: There is paucity of data on the outcomes of coronary artery bypass grafting (CABG) among patients presenting with ST-segment elevation myocardial infarction (STEMI). Methods: We queried the National Inpatient Sample database (2002-2016) for patients with STEMI who underwent CABG. We reported the trends in utilization of CABG for STEMI, and the associated in-hospital outcomes. Using multivariable analysis, we compared in-hospital outcomes in patients undergoing CABG on hospitalization day 1 vs. day 2 vs. day ≥3 , in the early (2002 to 2009) and contemporary cohorts (2012 to 2016). Results: Our analysis yielded 2,910,960 patients with STEMI, of whom 7.6% underwent CABG (9.6% in 2002 versus 3.9% in 2016, P trend <0.001). There was an increase in in-hospital mortality (5.8% in 2002 versus 7.6% in 2016, P trend <0.001) which corresponded to an increase in comorbidities burden among patients undergoing CABG. There was a rising trend in performing CABG on hospitalization day ≥ 3 corresponding to an increase in the utilization of MCS and pre-CABG PCI during the study years. CABG was more likely to be performed on admission day 1 in patients with anterior STEMI, cardiogenic shock or mechanical complications. In the early cohort, CABG on day 1 and day 2 was associated with higher in-hospital mortality, while in the contemporary cohort only CABG on day 1 was associated with higher in-hospital mortality compared with CABG on day ≥ 3. CABG on day 1 was associated with higher rate of cardiac arrest, hemorrhagic stroke, blood transfusion and cardiac tamponade in the earlier cohort, while in the more contemporary cohort it was associated with higher blood transfusion. Conclusions: There was a downtrend in performing CABG for STEMI, and an uptrend in in-hospital mortality after CABG. Patients undergoing emergent CABG on day 1 were more likely to have mechanical complications and cardiogenic shock and were associated with higher in-hospital mortality.

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