Percutaneous left atrial decompression in adults with refractory cardiogenic shock supported with veno-arterial extracorporeal membrane oxygenation

Autor:	Heather J. Ross, Eddy Fan, Filio Billia, Vivek Rao, Mosaad Alhussein, Eric Horlick, Mark Osten
Rok vydání:	2017
Předmět:	Pulmonary and Respiratory Medicine Adult Male medicine.medical_specialty Percutaneous Heart Diseases Decompression medicine.medical_treatment Shock Cardiogenic Pulmonary Edema 030204 cardiovascular system & hematology 03 medical and health sciences Ventricular Dysfunction Left Young Adult 0302 clinical medicine Extracorporeal Membrane Oxygenation Oxygen Consumption Internal medicine Extracorporeal membrane oxygenation Medicine Humans cardiovascular diseases Atrial septostomy Thrombus Atrial Septum business.industry Cardiogenic shock Myocardium Thrombosis Middle Aged medicine.disease Pulmonary edema Decompression Surgical Treatment Outcome 030228 respiratory system Ventricular assist device Cardiology Surgery Female Cardiology and Cardiovascular Medicine business
Zdroj:	Journal of cardiac surgery. 32(6)
ISSN:	1540-8191
Popis:	Background and Aim of the Study Left ventricular (LV) distention, a recognized complication in patients supported with veno-arterial extracorporeal membrane oxygenation (VA-ECMO) for refractory cardiogenic shock, can lead to pulmonary edema, increased myocardial oxygen consumption, and LV thrombus formation. Atrial septostomy was examined as a management strategy for LV distension. Methods Of 72 patients supported with VA-ECMO, seven patients underwent atrial septostomy through a trans-septal approach. The primary indication for atrial septostomy was refractory pulmonary edema. Results The mean time from ECMO initiation to LA decompression was 1.3 days (range 0-2 days). There was a 100% procedural success rate with improvement in pulmonary edema. Five patients survived to discharge with one patient exhibiting recovery of biventricular function, two patients were transplanted, one patient was decannulated, and one patient was transitioned to long-term durable ventricular assist device. Two patients died, one from multi-organ failure and one with severe anoxic brain injury. Conclusion Atrial septostomy is an effective method of LV decompression that can be performed safely with a high success rate.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::dbb98bdcc51deace6cdcc546acac5572 https://pubmed.ncbi.nlm.nih.gov/28497496 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
Nepřihlášeným uživatelům se plný text nezobrazuje	K zobrazení výsledku je třeba se přihlásit.