Outcome of extracorporeal membrane oxygenation support for complex high-risk elective percutaneous coronary interventions: A single-center experience

Heart Lung. 2015 Jul-Aug;44(4):309-13. doi: 10.1016/j.hrtlng.2015.03.005. Epub 2015 Apr 23.

Abstract

Objective: We report our initial experience with extracorporeal membrane oxygenation (ECMO) use in elective high-risk complex percutaneous coronary intervention (PCI).

Background: ECMO has been employed as hemodynamic support in patients with cardiac arrest and hemodynamic shock.

Methods: We performed a single-center prospectical study, enrolling all patients at very high-risk for coronary artery bypass grafting (CABG). Major adverse cardiac and cerebrovascular events (MACCE) were defined as a composite of death, acute myocardial infarction (MI), stroke and further need for revascularization.

Results: Twelve patients underwent elective high-risk PCI with ECMO support (mean age = 63.5 ± 8.7 years). The mean SYNTAX score was 30.1 ± 10.1. All PCI procedures were successful and no in-hospital MACCE was observed. At 6-months, neither death nor MI was noticed. Two patients (17%) required further revascularization, and one patient required chronic hemodialysis.

Conclusions: Elective high-risk PCI supported by ECMO is a viable alternative for patients who are at very high risk for CABG.

Keywords: Complex PCI; Extracorporeal membrane oxygenation support; High risk CABG; High-risk elective PCI; Left ventricular assistance device.

Publication types

  • Clinical Study

MeSH terms

  • Aged
  • Coronary Artery Bypass / methods
  • Coronary Artery Disease / surgery*
  • Elective Surgical Procedures / methods
  • Extracorporeal Membrane Oxygenation / methods*
  • Female
  • Heart Arrest / etiology
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / surgery
  • Myocardial Revascularization / methods
  • Percutaneous Coronary Intervention / methods*
  • Prospective Studies
  • Reoperation
  • Risk Factors
  • Stroke / etiology
  • Treatment Outcome