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

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.

Buying time! VA-ECMO as a bridge to successful reoperative cardiac surgery in a case of traumatic tricuspid valve injury

“…Cardiac surgery performed on patients in cardiogenic shock is associated with a high mortality. Preoperative ECMO in cardiogenic shock gives critically-ill patients a higher chance for surgical intervention and is associated with better surgical outcomes [ 2 ]. We report the only case of VA-ECMO utilized as a bridge to reoperative cardiac surgery in a patient with traumatic tricuspid valve (TV) injury and acute cardiogenic shock.…”