초록접수 현황
| 20F-118 | 구연 발표 |
Clinical outcome of extracorporeal membrane oxygenation bridged left ventricular assist device implantation
Suk kyung Lim, Yang hyun cho
Department of Thoracic & Cardiovascular Surgery, Sungkyunkwan University hospital, Samsung Medical Center, Seoul, Republic of Korea
Purpose : Left ventricle assist device (LVAD) implantation has shown good long-term
outcomes for treatment of end-stage heart failure. These patients are at risk of having critical cardiogenic shock. Veno-arterial extracorporeal membrane
oxygenation (VA-ECMO) provides emergent circulatory support for these patients with relatively quick installation. However, VA-ECMO is known for its high rates of complications such as increased bleeding tendency. The aim of this study is to describe outcomes of LVAD implantation.
Methods : Between August 2012 and August 2020, 66 patients underwent LVAD implantation and 17 patients of them were on VA-ECMO at the time of LVAD implantation.
The primary outcome was survival and secondary outcomes included right ventricle failure (RVF), bleeding and stroke.
Results : 22 patients underwent Heartmate II implantation and 44 patients underwent HVAD implantation. Kaplan-Meier survival analysis showed survival at 1 year was 89.8% in no ECMO to LVAD group and 82.5% in ECMO to LVAD group (p= 0.992) (Figure 1). Regarding postoperative complications, moderate to severe RVF occurred in 18.4% of the patients in no ECMO to LVAD group and 17.6% of the patients in ECMO to LVAD Group (Figure 2). Severe RVF occurred in 5 patients and 3 of them needed RVAD implantation. 7 Patients suffered moderate RVF. Incidences of bleeding and stroke were similar between the two groups.
Conclusion : VA-ECMO bridge to LVAD implantation in selected patients showed similar survival and complication rates compared with patients without an ECMO bridge.
Postoperative RVF was a challenging problem and further studies are needed to investigate predictors for RVF.
outcomes for treatment of end-stage heart failure. These patients are at risk of having critical cardiogenic shock. Veno-arterial extracorporeal membrane
oxygenation (VA-ECMO) provides emergent circulatory support for these patients with relatively quick installation. However, VA-ECMO is known for its high rates of complications such as increased bleeding tendency. The aim of this study is to describe outcomes of LVAD implantation.
Methods : Between August 2012 and August 2020, 66 patients underwent LVAD implantation and 17 patients of them were on VA-ECMO at the time of LVAD implantation.
The primary outcome was survival and secondary outcomes included right ventricle failure (RVF), bleeding and stroke.
Results : 22 patients underwent Heartmate II implantation and 44 patients underwent HVAD implantation. Kaplan-Meier survival analysis showed survival at 1 year was 89.8% in no ECMO to LVAD group and 82.5% in ECMO to LVAD group (p= 0.992) (Figure 1). Regarding postoperative complications, moderate to severe RVF occurred in 18.4% of the patients in no ECMO to LVAD group and 17.6% of the patients in ECMO to LVAD Group (Figure 2). Severe RVF occurred in 5 patients and 3 of them needed RVAD implantation. 7 Patients suffered moderate RVF. Incidences of bleeding and stroke were similar between the two groups.
Conclusion : VA-ECMO bridge to LVAD implantation in selected patients showed similar survival and complication rates compared with patients without an ECMO bridge.
Postoperative RVF was a challenging problem and further studies are needed to investigate predictors for RVF.
첨부파일 : Figures.pptx
책임저자: Yang hyun Cho
Department of Thoracic & Cardiovascular Surgery, Sungkyunkwan University hospital, Samsung Medical Center, Seoul, Republic of Korea
발표자: sukkyung lim, E-mail : skim0811@hanmail.net