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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
- Source :
- ABACUS. Repositorio de Producción Científica, Universidad Europea (UEM), RUC. Repositorio da Universidade da Coruña, Universitat Oberta de Catalunya (UOC), Interactive Cardiovascular and Thoracic Surgery, r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau, instname, RUC: Repositorio da Universidade da Coruña, Universidade da Coruña (UDC), r-IIS La Fe. Repositorio Institucional de Producción Científica del Instituto de Investigación Sanitaria La Fe
- Publication Year :
- 2019
-
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
- 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
Subjects
Details
- ISSN :
- 15699293
- Database :
- OpenAIRE
- Journal :
- ABACUS. Repositorio de Producción Científica, Universidad Europea (UEM), RUC. Repositorio da Universidade da Coruña, Universitat Oberta de Catalunya (UOC), Interactive Cardiovascular and Thoracic Surgery, r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau, instname, RUC: Repositorio da Universidade da Coruña, Universidade da Coruña (UDC), r-IIS La Fe. Repositorio Institucional de Producción Científica del Instituto de Investigación Sanitaria La Fe
- Accession number :
- edsair.doi.dedup.....2546f75031be33f21c1d9af51463efe2