Protracted aortic valve closure during peripheral veno-arterial extracorporeal life support
| Autor: | Fabrizio Oliva, Roberto Lorusso, Suzanne Kats, Samuel Heuts, Paul Roekaerts, Leo Veenstra, Jan Willem Sels, Elham Bidar, Giuseppe Maria Raffa, Ehsan Natour, Rick Schreurs, Nuccia Morici, Paolo Meani, Giovanna Viola, Alice Sacco, Martijn Gilbers, Thijs Delnoij, Rob G. H. Driessen, Jos G. Maessen |
|---|---|
| Přispěvatelé: | MUMC+: MA Med Staf Spec Cardiologie (9), MUMC+: MA Medische Staf IC (9), RS: Carim - Vessels, MUMC+: MA Med Staf Artsass CTC (9), RS: CARIM - R2.12 - Surgical intervention, RS: CARIM - R2 - Cardiac function and failure, Intensive Care, MUMC+: MA Intensive Care (3), RS: Carim - V04 Surgical intervention, MUMC+: MA Off Man Secr IC (9), MUMC+: MA Arts Assistenten IC (9), Fysiologie, RS: CARIM - R1.06 - Genetic Epidemiology and Genomics of cardiovascular diseases, Promovendi CD, MUMC+: MA Med Staf Spec CTC (9), MUMC+: MA Med Staf Artsass Cardiologie (9), RS: CARIM - R2.11 - Experimental atrial fibrillation, RS: CARIM - R2.08 - Electro mechanics, MUMC+: MA Cardiothoracale Chirurgie (3), CTC |
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Aortic valve
Graft Rejection Male medicine.medical_treatment 030204 cardiovascular system & hematology extracorporeal life support 0302 clinical medicine VENTRICULAR ASSIST DEVICE CARDIAC-ARREST intra-aortic balloon LV unloading Heart Valve Prosthesis Implantation General Medicine Middle Aged Original Papers Peripheral medicine.anatomical_structure surgical procedures operative Treatment Outcome Aortic Valve Cerebrovascular Circulation Cardiology Female ECMO Cardiology and Cardiovascular Medicine ECHOCARDIOGRAPHY Safety Research Adult medicine.medical_specialty CONTINUOUS-FLOW Shock Cardiogenic Extracorporeal 03 medical and health sciences Extracorporeal Membrane Oxygenation Afterload Internal medicine medicine Extracorporeal membrane oxygenation MANAGEMENT Humans Radiology Nuclear Medicine and imaging ATRIAL SEPTOSTOMY Intra-aortic balloon pump Aged Retrospective Studies Advanced and Specialized Nursing Intra-Aortic Balloon Pumping business.industry MEMBRANE-OXYGENATION Hemodynamics COUNTERPULSATION 030228 respiratory system Life support CARDIOGENIC-SHOCK Heart-Assist Devices OBSTRUCTION business Complication |
| Zdroj: | Perfusion Perfusion, 34(1), 35-41. SAGE Publications Ltd |
| ISSN: | 1477-111X 0267-6591 |
| Popis: | Background: Left ventricular (LV) afterload increase with protracted aortic valve (AV) closure may represent a complication of veno-arterial extracorporeal membrane oxygenation (V-A ECMO). The aim of the present study was to assess the effects of an intra-aortic balloon pump (IABP) to overcome such a hemodynamic shortcoming in patients submitted to peripheral V-A ECMO. Methods: Among 184 adult patients who were treated with peripheral V-A ECMO support at Medical University Center Maastricht Hospital between 2007 and 2018, patients submitted to IABP implant for protracted AV closure after V-A ECMO implant were retrospectively identified. All clinical and hemodynamic data, including echocardiographic monitoring, were collected and analyzed. Results: During the study period, 10 subjects (mean age 60 years old, 80% males) underwent IABP implant after peripheral V-A ECMO positioning due to the diagnosis of protracted AV closure and inefficient LV unloading as assessed by echocardiography and an absence of pulsation in the arterial pressure wave. Recovery of blood pressure pulsatility and enhanced LV unloading were observed in 8 patients after IABP placement, with no significant differences in the main hemodynamic parameters, inotropic therapy or in the ECMO flow (p=0.48). The weaning rate in this patient subgroup (mean ECMO duration 8 days), however, was only 10%, with another patient finally transplanted, leading to a 20% survival-to-hospital discharge. Conclusion: IABP placement was an effective solution in order to reverse the protracted AV closure and impaired LV unloading observed during peripheral V-A ECMO support. However, the impact on the weaning rate and survival needs further investigations. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|