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Background: Patients suffering from cardiogenic shock, with no response to conventional therapy, may significantly improve when put on support devices such as extracorporeal membrane oxygenation (ECMO), which maintains systemic and pulmonary circulation, and decongests the heart. This publication presents authors' own experience in qualifying and treating patients with cardiogenic shock, with the use of veno-arterial (VA) ECMO modality., Aim: The main goal of the study was to analyse factors influencing outcome of VA ECMO therapy in patients with cardiogenic shock. Survival data were compared for patients surviving treatment (n = 12, 41%), and for patients who died while VA ECMO., Methods: Retrospective study included all patients treated between February 2009, when ECMO was first used in the clinic, and March 2015. Of those, 29 patients were treated with VA ECMO for respiratory support. Mean patient age was 42 years; 19 (66%) patients were male, and 10 (34%) patients were female., Results: Total in-hospital mortality rate was 59% (17/29). No difference was observed as to patient age, sex, body height, mode of hospital admission, comorbidities or left ventricular ejection fraction at hospital admission, when comparing survivors and patients who died despite treatment. The following parameters were analysed: number of days on VA ECMO, troponin levels during first days from treatment onset, platelet transfusions, and duration of mechanical ventilation. No significant differences were observed between the groups. Surviving patients were significantly longer hospitalised (p = 0.016), including a longer stay in the intensive care unit (p = 0.03)., Conclusions: VA ECMO is an acceptable therapy for patients in a severe state of cardiogenic shock. In-hospital mortality rate was 59%, and 41% patients (12 subjects) were successfully treated with VA ECMO in course of cardiogenic shock.

Introduction: In our department left ventricular aneurysmectomy was performed using only classic Cooley technique until 1989. Since then a modified technique was introduced: left ventricular geometry reconstruction modo Stoney simultaneously with the excision of scarred endocardium., Aim: Comparison of early clinical results after left ventricular aneurysmectomy using classic (Group A) and modified technique (Group B)., Material and Methods: Retrospective data analysis of early clinical outcome of patients (pts) operated from 1989 to 2000: classic technique 74 pts [63M (85.1%); 11F (14.9%); average age 52.26 +/- 10.35 years], modified technique 86 pts [74M (86%); 12F (14%); average age 55.83 +/- 9.3]., Results: No statistically significant differences between groups considering number of critically stenosed coronary arteries, left ventricular ejection fraction and left ventricular diameters were observed. Mean number of bypass grafts (gr. A 1.55, gr. B 1.69); aortic crossclamping time (gr. A 48.1 (24-77) +/- 12.9; gr. B 50.9 (0-91) +/- 16.1) were not significantly different between groups. In gr. A, 11 (14.8%) pts died: low output syndrome (LOS) 3 pts, LOS and ventricular dysrhythmias (VD) 5 pts, VD 3 pts. In gr. B 4 (4.6%) pts died: LOS 3 pts; LOS and VD 1 pt. Among other complications LOS and VD occurred significantly more frequently in gr. A. In both groups average postoperative ejection fraction increased; twice higher in gr. B than A., Conclusions: Modified technique: 1. Significantly decreases incidence of ventricular dysrhythmias in comparison to classic technique. 2. Significantly lowers incidence of low output syndrome and mortality rates in comparison to classic technique.