Postcardiotomy veno-arterial membrane oxygenation as a bridge to heart replacement therapies.
Fausto Biancari, René Schramm, Olivier Bouchot et al.
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From the abstract
Data on the outcome of veno-arterial extracorporeal membrane oxygenation (V-A-ECMO) support as a bridge to replacement therapies are scarce. We investigated the outcome of V-A-ECMO support after adult cardiac surgery as a bridge to ventricular assist device (VAD) implantation and/or heart transplantation.
Reported results
Ninety-four consecutive patients were treated at 14 European centers of cardiac transplantation from 2010 to 2024. In-hospital mortality after replacement therapy was 31.9%, while it was 35.2% (19/54 patients) after primary VAD implantation and 27.5% (11/40 patients) after primary heart transplantation (p = 0.429) after V-A-ECMO. Five-year all-cause mortality of the overall series was 52.4%.
Authors' conclusions
The present findings support a bridge policy to heart replacement in selected postcardiotomy V-A-ECMO patients. Primary heart transplantation after V-A-ECMO support may be associated with better survival. The small size of this series and its results suggest that a larger study is needed to confirm these findings and could strengthen external validity and enhance the applicability of the results across different…