Original articleAdult cardiacExtracorporeal Life Support for Cardiogenic Shock or Cardiac Arrest Due to Acute Coronary Syndrome
Section snippets
Patients and Methods
The Institutional Review Board of the Sakurakai Takahashi Hospital approved this study and informed consent was waived because the patients had life-threatening emergencies. Between January 2000 and December 2010, a total of 256 patients received ECLS at our hospital. From this cohort, patients who presented with ACS were included in the study. The following conditions excluded patients from the analysis: (1) ECLS was initiated more than 48 hours after admission; and (2) the reason for
Patient Characteristics
During the period selected for study, 98 patients were eligible for inclusion. Baseline characteristics are shown in Table 1. Mean age was 72 ± 12 years. On hospital arrival, 28 patients (28.6%) had cardiogenic shock, and 36 (36.7%) had cardiac arrest. Emergency PCI was performed in 92 patients and isolated emergency CABG in 2. The remaining 4 patients did not undergo revascularization because 1 had AMI caused by refractory coronary spasm, 1 died of left ventricular free wall rupture before
Comment
This retrospective analysis of data from 98 patients with ACS complicated by cardiogenic shock or cardiac arrest refractory to conventional therapy who received ECLS support and mostly underwent early revascularization revealed high in-hospital mortality; however, it also showed a higher than 30% in-hospital survival in an extremely critical population of patients. Additionally, the data show that unsuccessful angioplasty, asystole or PEA before ECLS introduction, and ECLS-related complications
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Complications related to veno-arterial extracorporeal membrane oxygenation in patients with acute myocardial infarction: VA-ECMO complications in AMI
2022, Journal of CardiologyCitation Excerpt :Veno-arterial extracorporeal membrane oxygenation (V-A ECMO) for refractory cardiac arrest or cardiogenic shock caused by AMI has been the last resort [2], and clinical guidelines recommend V-A ECMO for such severest cases as class IIb [3,4]. However, V-A ECMO is also known to be associated with various complications such as bleeding, vascular complications, infection, and neurological injuries [2,5–7]. Among several complications, bleeding is the most frequent complication in primary percutaneous coronary intervention (PCI) for AMI [8], partly because anticoagulation and antiplatelet therapy are indispensable in primary PCI [9].
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