Postoperative Extracorporeal Membrane Oxygenation Support for Acute Type A Aortic Dissection.
Ann Thorac Surg
; 104(3): 827-833, 2017 Sep.
Article
in En
| MEDLINE
| ID: mdl-28267980
ABSTRACT
BACKGROUND:
Few studies have investigated the use of postoperative extracorporeal membrane oxygenation (ECMO) in acute type A aortic dissection (aTAAD). We identified aTAAD surgical patients at risk of ECMO implantation postoperatively and analyzed the prognosis of these patients.METHODS:
We retrospectively reviewed 162 consecutive aTAAD patients undergoing operations from January 2008 to December 2015. Patient data were analyzed for risk factors leading to an ECMO requirement. Short-term and long-term outcomes in patients who did and did not require ECMO were compared.RESULTS:
Postoperative ECMO was required in 20 patients (12.3%), and in-hospital mortality was higher in the ECMO group (65.0% vs 8.5%, p < 0.001). Factors predicting postoperative ECMO were preoperative hemodynamic instability (p = 0.049), aortic cross-clamp time (p = 0.036), and postoperative peak creatinine kinase-MB (p = 0.002). ECMO survivors presented at a younger age (p = 0.036) and had a less postoperative blood transfusion (p = 0.034) than ECMO nonsurvivors. The postdischarge survival rate was equivalent in patients with or without ECMO support.CONCLUSIONS:
Although postoperative ECMO is an important predictor of in-hospital death, this pilot study showed that aTAAD patients supported with postoperative ECMO who survive to hospital discharge have a long-term survival comparable to patients who did not receive ECMO.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Postoperative Care
/
Extracorporeal Membrane Oxygenation
/
Aortic Aneurysm, Thoracic
/
Aortic Dissection
Type of study:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Ann Thorac Surg
Year:
2017
Document type:
Article
Affiliation country:
Taiwan