Impact of extra-corporeal life support (ECLS) cannulation strategy on outcome after durable mechanical circulation support system implantation on behalf of durable MCS after ECLS Study Group.
Mechanical circulatory support (MCS)
cannulation strategy
extra-corporeal life support (ECLS)
outcome
ventricular assist device
Journal
Annals of cardiothoracic surgery
ISSN: 2225-319X
Titre abrégé: Ann Cardiothorac Surg
Pays: China
ID NLM: 101605877
Informations de publication
Date de publication:
May 2021
May 2021
Historique:
entrez:
23
6
2021
pubmed:
24
6
2021
medline:
24
6
2021
Statut:
ppublish
Résumé
The literature on outcomes of patients requiring durable mechanical circulatory support (MCS) after extra-corporeal life support (ECLS) is limited. The aim of this study was to investigate the impact of preoperative ECLS cannulation on postoperative outcome after durable MCS implantation. The durable MCS after ECLS registry is a multicenter retrospective study that gathered data on consecutive patients who underwent durable MCS implantation after ECLS between January 2010 and August 2018 in eleven high volume European centers. Patients who underwent the implantation of total artificial heart, pulsatile pumps, or first-generation pumps after ECLS were excluded from the analysis. The remaining patients were divided into two groups; central ECLS group (cECLS) and peripheral ECLS group (pECLS). A 1:1 propensity score analysis was performed to identify two matched groups. The outcome of these two groups was compared. A total of 531 durable MCS after ECLS were implanted during this period. The ECLS cannulation site was peripheral in 87% (n=462) and central in 13% (n=69) of the patients. After excluding pulsatile pumps and total artificial heart patients, a total of 494 patients remained (pECLS =434 patients, cECLS =60 patients). A 1:1 propensity score analysis resulted in 2 matched groups (each 55 patients) with median age of 54 years (48-60 years) in cECLS group and 54 years (43-60 years) in pECLS group. HeartWare HVAD (Medtronic, Minneapolis, MN) was implanted in the majority of the patients (cECLS =71% The cannulation strategy of ECLS appears to have no impact on the post-operative outcome after durable MCS implantation.
Sections du résumé
BACKGROUND
BACKGROUND
The literature on outcomes of patients requiring durable mechanical circulatory support (MCS) after extra-corporeal life support (ECLS) is limited. The aim of this study was to investigate the impact of preoperative ECLS cannulation on postoperative outcome after durable MCS implantation.
METHODS
METHODS
The durable MCS after ECLS registry is a multicenter retrospective study that gathered data on consecutive patients who underwent durable MCS implantation after ECLS between January 2010 and August 2018 in eleven high volume European centers. Patients who underwent the implantation of total artificial heart, pulsatile pumps, or first-generation pumps after ECLS were excluded from the analysis. The remaining patients were divided into two groups; central ECLS group (cECLS) and peripheral ECLS group (pECLS). A 1:1 propensity score analysis was performed to identify two matched groups. The outcome of these two groups was compared.
RESULTS
RESULTS
A total of 531 durable MCS after ECLS were implanted during this period. The ECLS cannulation site was peripheral in 87% (n=462) and central in 13% (n=69) of the patients. After excluding pulsatile pumps and total artificial heart patients, a total of 494 patients remained (pECLS =434 patients, cECLS =60 patients). A 1:1 propensity score analysis resulted in 2 matched groups (each 55 patients) with median age of 54 years (48-60 years) in cECLS group and 54 years (43-60 years) in pECLS group. HeartWare HVAD (Medtronic, Minneapolis, MN) was implanted in the majority of the patients (cECLS =71%
CONCLUSIONS
CONCLUSIONS
The cannulation strategy of ECLS appears to have no impact on the post-operative outcome after durable MCS implantation.
Identifiants
pubmed: 34159116
doi: 10.21037/acs-2020-cfmcs-251
pii: acs-10-03-353
pmc: PMC8185378
doi:
Types de publication
Journal Article
Langues
eng
Pagination
353-363Informations de copyright
2021 Annals of Cardiothoracic Surgery. All rights reserved.
Déclaration de conflit d'intérêts
Conflicts of Interest: The authors have no conflicts of interest to declare.
Références
Resuscitation. 2017 Dec;121:151-157
pubmed: 28870718
Artif Organs. 2015 Aug;39(8):719-23
pubmed: 25912873
J Thorac Cardiovasc Surg. 2020 Nov;160(5):1207-1216.e44
pubmed: 31864699
J Thorac Cardiovasc Surg. 2018 Apr;155(4):1607-1618.e6
pubmed: 29361299
Artif Organs. 2014 Sep;38(9):727-32
pubmed: 25234756
JACC Heart Fail. 2016 Sep;4(9):698-708
pubmed: 27179833
Heart Lung Circ. 2008;17 Suppl 4:S41-7
pubmed: 18964254
Eur J Heart Fail. 2018 Jan;20(1):178-186
pubmed: 28949079
ASAIO J. 2014 Mar-Apr;60(2):189-92
pubmed: 24399062
Semin Thorac Cardiovasc Surg. 2017 Summer;29(2):188-195
pubmed: 28823327
J Am Coll Cardiol. 2020 Dec 22;76(25):2956-2964
pubmed: 33334424
Artif Organs. 2014 Jul;38(7):549-55
pubmed: 24392890