MedStar Authors catalog › Details for: Contemporary Use of Veno-Arterial Extracorporeal Membrane Oxygenation for Refractory Cardiogenic Shock in Acute Coronary Syndrome.
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Contemporary Use of Veno-Arterial Extracorporeal Membrane Oxygenation for Refractory Cardiogenic Shock in Acute Coronary Syndrome.

by Negi, Smita I; Sokolovic, Mladen; Koifman, Edward; Kiramijyan, Starkis; Torguson, Rebecca; Lindsay, Joseph; Ben-Dor, Itsik; Suddath, William O; Pichard, Augusto D; Satler, Lowell F; Waksman, Ron.
Citation: Journal of Invasive Cardiology. 28(2):52-7, 2016 Feb.Journal: The Journal of invasive cardiology.Published: 2016ISSN: 1042-3931.Full author list: Negi SI; Sokolovic M; Koifman E; Kiramijyan S; Torguson R; Lindsay J; Ben-Dor I; Suddath W; Pichard A; Satler L; Waksman R.UI/PMID: 26689415.Subject(s): IN PROCESS -- NOT YET INDEXEDInstitution(s): MedStar Heart & Vascular Institute | MedStar Washington Hospital CenterDepartment(s): Surgery/Surgical Critical CareActivity type: Journal Article.Medline article type(s): Journal ArticleOnline resources: Click here to access online Abbreviated citation: J Invasive Cardiol. 28(2):52-7, 2016 Feb.Local Holdings: Available online from MWHC library: 2001 - present, Available in print through MWHC library: 2003 - 2008.Abstract: BACKGROUND: Refractory cardiogenic shock (RCS) in acute myocardial infarction (AMI) is associated with high rates of mortality. Smaller ventricular assist devices, such as the intraaortic balloon pump, provide limited support. Venoarterial extracorporeal membrane oxygenation (VA-ECMO) offers more robust mechanical ventricular support, but is not widely utilized by interventional cardiologists. This study aimed to evaluate the patient characteristics and outcomes of VA-ECMO with RCS in the setting of AMI.Abstract: METHODS AND RESULTS: A retrospective chart review of all VA-ECMO cannulations between 2009 and 2014 was performed, and patients with an indication of RCS in AMI were identified. A total of 15 patients underwent VA-ECMO placement for AMI with RCS. One-third of these patients presented with out-of-hospital cardiac arrest, and 60% had ST-elevation myocardial infarction. The Intraaortic balloon pump was placed in addition to VA-ECMO in 60% of patients. Median duration of VA-ECMO support was 45 hours. Successful wean off VA-ECMO was obtained in 50% of the patients, and vascular complications occurred in 53% of patients. The survival rate at discharge was 47%, and all survivors were alive at 30 days post discharge.Abstract: CONCLUSION: VA-ECMO is infrequently used in patients for cardiopulmonary resuscitation in the AMI setting. When used judiciously, it has good clinical outcomes in this group of patients. However, use of VA-ECMO should be individualized based on vascular anatomy for best results. Close cooperation among interventional cardiologists, cardiovascular surgeons, cardiologists, cardiac intensivists, and perfusionists is essential for success of this therapy for RCS in AMI.

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