Clinical outcomes of venoarterial extracorporeal life support in 462 patients: Single‐center experience.

This study aims to investigate the outcomes of venoarterial extracorporeal life support (VA‐ECLS) in a large single‐center patient cohort regarding survival and adverse events. Between June 2009 and March 2019, 462 consecutive patients received VA‐ECLS. The mean age was 66.2 ± 11.9 years. Two patient groups were identified: Group 1—patients with ECLS due to postcardiotomy shock (PCS) after cardiac surgery (PCS, n = 357); Group 2—patients with ECLS due to cardiogenic shock (CS) without previous surgery (nonPCS, n = 105). The primary end point was overall in‐hospital survival, while secondary end points were adverse events during the study period. Overall, the in‐hospital survival rate was 26%. There was no statistically significant difference between the groups: 26.3% for PCS and 24.8% for nonPCS, respectively (P >.05). Weaning from VA‐ECLS was possible in 44.3% for PCS and in 29.5% for nonPCS (P =.004). The strong predictors of overall mortality were postoperative hepatic dysfunction (OR = 14.362, 95%CI = 1.948‐105.858), cardiopulmonary resuscitation > 30 minutes (OR = 6.301, 95%CI = 1.488‐26.673), bleeding with a need for revision (OR = 2.123, 95%CI = 1.343‐3.355), and previous sternotomy (OR = 2.077, 95%CI = 1.021‐4.223). Despite its low survival rates, VA‐ECLS therapy is the last resort and the only lifesaving option for patients in refractory CS. In contrast, there is still a lack of evidence for VA‐ECLS in PCS patients. Future studies are warranted to evaluate the outcomes of VA‐ECLS therapy after cardiac surgery. [ABSTRACT FROM AUTHOR]