1. Venoarterial extracorporeal membrane oxygenation with or without simultaneous intra-aortic balloon pump support as a direct bridge to heart transplantation: Results from a nationwide Spanish registry
- Author
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Javier Segovia-Cubero, Daniela Hervás-Sotomayor, Gonzalo Barge-Caballero, Eduardo Barge-Caballero, Javier Muñiz, Gregorio Rábago-Juan-Aracil, Sonia Mirabet-Pérez, Marta Farrero-Torres, Juan F. Delgado, Diego Rangel-Sousa, Luis Almenar-Bonet, Ana Portolés-Ocampo, José González-Costello, María G. Crespo-Leiro, Francisco González-Vílchez, Luis de la Fuente-Galán, José Luis Lambert-Rodríguez, María A. Castel-Lavilla, Manuel Martínez-Sellés, and Iris P. Garrido-Bravo
- Subjects
Extracorporeal membrane oxygenation, Heart transplantation, Intra-aortic balloon pump ,Pulmonary and Respiratory Medicine ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,Heart transplantation ,03 medical and health sciences ,0302 clinical medicine ,Extracorporeal Membrane Oxygenation ,Internal medicine ,medicine ,Extracorporeal membrane oxygenation ,Odds Ratio ,Humans ,Hospital Mortality ,Registries ,Tecnología médica ,Intra-aortic balloon pump ,Retrospective Studies ,Sistema cardiovascular ,Heart Failure ,Intra-Aortic Balloon Pumping ,Corazón ,business.industry ,Hazard ratio ,Odds ratio ,Middle Aged ,Confidence interval ,Log-rank test ,Transplantation ,Survival Rate ,Trasplante de órganos ,surgical procedures, operative ,030228 respiratory system ,Spain ,Cardiology ,Heart Transplantation ,Surgery ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
OBJECTIVES To investigate the potential clinical benefit of an intra-aortic balloon pump (IABP) in patients supported with venoarterial extracorporeal membrane oxygenation (VA-ECMO) as a bridge to heart transplantation (HT). METHODS We studied 169 patients who were listed for urgent HT under VA-ECMO support at 16 Spanish institutions from 2010 to 2015. The clinical outcomes of patients under simultaneous IABP support (n = 73) were compared to a control group of patients without IABP support (n = 96). RESULTS There were no statistically significant differences between the IABP and control groups with regard to the cumulative rates of transplantation (71.2% vs 81.2%, P = 0.17), death during VA-ECMO support (20.6% vs 14.6%, P = 0.31), transition to a different mechanical circulatory support device (5.5% vs 5.2%, P = 0.94) or weaning from VA-ECMO support due to recovery (2.7% vs 0%, P = 0.10). There was a higher incidence of bleeding events in the IABP group (45.2% vs 25%, P = 0.006; adjusted odds ratio 2.18, 95% confidence interval 1.02–4.67). In-hospital postoperative mortality after HT was 34.6% in the IABP group and 32.5% in the control group (P = 0.80). One-year survival after listing for urgent HT was 53.3% in the IABP group and 52.2% in the control group (log rank P = 0.75). Multivariate adjustment for potential confounders did not change this result (adjusted hazard ratio 0.94, 95% confidence interval 0.56–1.58). CONCLUSIONS In our study, simultaneous IABP therapy in transplant candidates under VA-ECMO support did not significantly reduce morbidity or mortality. Sin financiación 1.675 JCR (2019) Q3, 98/138 Cardiac & Cardiovascular Systems, 123/210 Surgery; Q4, 53/64 Respiratory System 0.660 SJR (2019) Q2, 137/362 Cardiology and Cardiovascular Medicine, 63/147 Pulmonary and Respiratory Medicine, 138/451 Surgery No data IDR 2019 UEM
- Published
- 2019