Peripheral venoarterial extracorporeal membrane oxygenation for periprocedural Cardiogenic shock during interventional cardiology

ABSTRACT Background: Cardiogenic shock (CS) is uncommon in the cardiac catheterization laboratory (CCL) among patients undergoing coronary angiography. Periprocedural CS is more frequent in high-risk patients and in technically demanding procedures. Aim: To describe the clinical outcomes of patien...

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Autores principales:	Verdugo,Fernando J., Cataldo,Pabla, Sandoval,Jorge, Pineda,Fernando, Dauvergne,Christian, Duarte,Manuel, Bonta,Camila, Iturra,Sebastián, Olivares,Gabriel, Concha,Marcelo, Rossel,Víctor
Lenguaje:	English
Publicado:	Sociedad Médica de Santiago 2020
Materias:	Cardiac Catheterization Extracorporeal Membrane Oxygenation Shock, Cardiogenic
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872020000901295
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spelling	oai:scielo:S0034-988720200009012952020-12-26Peripheral venoarterial extracorporeal membrane oxygenation for periprocedural Cardiogenic shock during interventional cardiologyVerdugo,Fernando J.Cataldo,PablaSandoval,JorgePineda,FernandoDauvergne,ChristianDuarte,ManuelBonta,CamilaIturra,SebastiánOlivares,GabrielConcha,MarceloRossel,Víctor Cardiac Catheterization Extracorporeal Membrane Oxygenation Shock, Cardiogenic ABSTRACT Background: Cardiogenic shock (CS) is uncommon in the cardiac catheterization laboratory (CCL) among patients undergoing coronary angiography. Periprocedural CS is more frequent in high-risk patients and in technically demanding procedures. Aim: To describe the clinical outcomes of patients who underwent peripheral venoarterial extracorporeal membrane oxygenation (pVA-ECMO) for CS associated with interventional cardiology procedures. Material and Methods: Review of clinical records of seven patients treated between January 2014 and October 2018. Results: pVA-ECMO was implanted within 6 hours of the interventional cardiology procedure. All patients had coronary artery disease and one of them also had symptomatic severe aortic stenosis. One patient entered the CCL in cardiac arrest. Percutaneous coronary intervention (PCI) was performed in all patients; four patients underwent an emergency procedure and five patients experienced PCI complications. One patient undergoing transcatheter aortic valve replacement suffered acute severe aortic regurgitation. An intra-aortic balloon pump was inserted at the CCL in five patients. Six patients experienced cardiac arrest. Mean SAVE score was -4.3 and baseline lactate 55 mg/dl. pVA-ECMO mean duration was 5 ± 4 days. Survival after both hospital discharge and 12 months of follow-up was 85.7% Regarding vascular access complications, we observed one access site hematoma and one episode of cannulation site bleeding requiring surgical repair. Conclusions: pVA-ECMO should be considered in patients with periprocedural CS as a bridge to recovery. Its use was associated with improved clinical outcomes in this series.info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.148 n.9 20202020-09-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872020000901295en10.4067/S0034-98872020000901295
institution	Scielo Chile
collection	Scielo Chile
language	English
topic	Cardiac Catheterization Extracorporeal Membrane Oxygenation Shock, Cardiogenic
spellingShingle	Cardiac Catheterization Extracorporeal Membrane Oxygenation Shock, Cardiogenic Verdugo,Fernando J. Cataldo,Pabla Sandoval,Jorge Pineda,Fernando Dauvergne,Christian Duarte,Manuel Bonta,Camila Iturra,Sebastián Olivares,Gabriel Concha,Marcelo Rossel,Víctor Peripheral venoarterial extracorporeal membrane oxygenation for periprocedural Cardiogenic shock during interventional cardiology
description	ABSTRACT Background: Cardiogenic shock (CS) is uncommon in the cardiac catheterization laboratory (CCL) among patients undergoing coronary angiography. Periprocedural CS is more frequent in high-risk patients and in technically demanding procedures. Aim: To describe the clinical outcomes of patients who underwent peripheral venoarterial extracorporeal membrane oxygenation (pVA-ECMO) for CS associated with interventional cardiology procedures. Material and Methods: Review of clinical records of seven patients treated between January 2014 and October 2018. Results: pVA-ECMO was implanted within 6 hours of the interventional cardiology procedure. All patients had coronary artery disease and one of them also had symptomatic severe aortic stenosis. One patient entered the CCL in cardiac arrest. Percutaneous coronary intervention (PCI) was performed in all patients; four patients underwent an emergency procedure and five patients experienced PCI complications. One patient undergoing transcatheter aortic valve replacement suffered acute severe aortic regurgitation. An intra-aortic balloon pump was inserted at the CCL in five patients. Six patients experienced cardiac arrest. Mean SAVE score was -4.3 and baseline lactate 55 mg/dl. pVA-ECMO mean duration was 5 ± 4 days. Survival after both hospital discharge and 12 months of follow-up was 85.7% Regarding vascular access complications, we observed one access site hematoma and one episode of cannulation site bleeding requiring surgical repair. Conclusions: pVA-ECMO should be considered in patients with periprocedural CS as a bridge to recovery. Its use was associated with improved clinical outcomes in this series.
author	Verdugo,Fernando J. Cataldo,Pabla Sandoval,Jorge Pineda,Fernando Dauvergne,Christian Duarte,Manuel Bonta,Camila Iturra,Sebastián Olivares,Gabriel Concha,Marcelo Rossel,Víctor
author_facet	Verdugo,Fernando J. Cataldo,Pabla Sandoval,Jorge Pineda,Fernando Dauvergne,Christian Duarte,Manuel Bonta,Camila Iturra,Sebastián Olivares,Gabriel Concha,Marcelo Rossel,Víctor
author_sort	Verdugo,Fernando J.
title	Peripheral venoarterial extracorporeal membrane oxygenation for periprocedural Cardiogenic shock during interventional cardiology
title_short	Peripheral venoarterial extracorporeal membrane oxygenation for periprocedural Cardiogenic shock during interventional cardiology
title_full	Peripheral venoarterial extracorporeal membrane oxygenation for periprocedural Cardiogenic shock during interventional cardiology
title_fullStr	Peripheral venoarterial extracorporeal membrane oxygenation for periprocedural Cardiogenic shock during interventional cardiology
title_full_unstemmed	Peripheral venoarterial extracorporeal membrane oxygenation for periprocedural Cardiogenic shock during interventional cardiology
title_sort	peripheral venoarterial extracorporeal membrane oxygenation for periprocedural cardiogenic shock during interventional cardiology
publisher	Sociedad Médica de Santiago
publishDate	2020
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872020000901295
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Peripheral venoarterial extracorporeal membrane oxygenation for periprocedural Cardiogenic shock during interventional cardiology

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