Compatibility of Novel Cardiogenic Shock Phenotypes from the Cardiogenic Shock Working Group (CSWG) with the SCAI Staging System

Abstract

HT), early-and long-term outcomes, and risk factors for need of VA-ECMO and for early mortality in these patients. Methods: We included 135 adult heart recipients who met the criteria of the last ISHLT definition for GD from 3 cardiac centers over a 10-year period. Pre-transplant, intra-operative, post-transplant, and donor characteristics were analyzed and compared between GD recipients treated with (n=66) or without VA-ECMO (n=69). Multivariate analysis for the need of VA-ECMO and hospital mortality were performed. The mean follow-up was 66.2 §45 months and was 100% complete. Results: The overall incidence of GD (30%) and of VA-ECMO use increased over time. We did not identify any predictive factors for VA-ECMO use, but patients who required VA-ECMO had higher serum lactate levels and higher inotrope doses after HT. In the medical and VA-ECMO groups, the overall survival rates were 83% and 42% at 1 year, and 78% and 40% at 5 years, respectively. Delayed implantation of VA-ECMO and post-operative bleeding were strongly associated with increased hospital mortality. Conclusion:The incidence of GD increased over the time, and the need of VA-ECMO for patients with GD remains difficult to predict. The early mortality decreased over the time but remains high in patients who required VA-ECMO, especially in patients with a delayed implantation.