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Extracorporeal Mechanical Circulatory Support after Pulmonary Thromboendarterectomy: Experience of One Center.
- Source :
-
Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia [Ann Thorac Cardiovasc Surg] 2024; Vol. 30 (1). - Publication Year :
- 2024
-
Abstract
- Purpose: Pulmonary thromboendarterectomy (PTE) is the treatment for patients with chronic thromboembolic disease. In the immediate postoperative period, some patients may still experience life-threatening complications such as reperfusion lung injury, airway bleeding, and persistent pulmonary hypertension with consequent right ventricular dysfunction. These issues may require support with extracorporeal membrane oxygenation (ECMO) as a bridge to recovery or lung transplantation. This study aims to analyze our series of PTEs that require ECMO.<br />Methods: A descriptive and retrospective analysis of all PTE performed at the Favaloro Foundation University Hospital was conducted between March 2013 and December 2023.<br />Results: A total of 42 patients underwent PTE with a median age of 47 years (interquartile range: 26-76). The incidence of patients with ECMO was 26.6%, of which 53.6% were veno-venous (VV) ECMO. Preoperatively, a low cardiac index (CI), high right and left filling pressures, and high total pulmonary vascular resistances (PVRs) were associated with ECMO with a statistically significant relationship. The hospital mortality was 11.9%, and the mortality in the ECMO group was 45.5%, with a statistically significant relationship. Veno-arterial ECMO has a worse prognosis than VV ECMO.<br />Conclusions: Preoperatively, a low CI, high right and left filling pressures, and high total PVRs were associated with ECMO after PTE.
- Subjects :
- Humans
Middle Aged
Male
Retrospective Studies
Female
Treatment Outcome
Adult
Aged
Time Factors
Risk Factors
Pulmonary Artery physiopathology
Pulmonary Artery surgery
Hypertension, Pulmonary mortality
Hypertension, Pulmonary physiopathology
Hypertension, Pulmonary surgery
Extracorporeal Membrane Oxygenation mortality
Extracorporeal Membrane Oxygenation adverse effects
Endarterectomy adverse effects
Endarterectomy mortality
Pulmonary Embolism mortality
Pulmonary Embolism surgery
Pulmonary Embolism physiopathology
Hospital Mortality
Subjects
Details
- Language :
- English
- ISSN :
- 2186-1005
- Volume :
- 30
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia
- Publication Type :
- Academic Journal
- Accession number :
- 39111866
- Full Text :
- https://doi.org/10.5761/atcs.oa.24-00070