Tomasello Salvatore Davide, Boukhris Marouane, Ganyukov Vladimir, Galassi Alfredo R, Shukevich Dmitri, Haes Boris, Kochergin Nikita, Tarasov Roman, Popov Vadim, Barbarash Leonid
Department of Medical Sciences and Pediatrics, Catheterization Laboratory and Cardiovascular Interventional Unit, Cannizzaro Hospital, University of Catania, Via Messina 829, 95126 Catania, Italy.
Department of Medical Sciences and Pediatrics, Catheterization Laboratory and Cardiovascular Interventional Unit, Cannizzaro Hospital, University of Catania, Via Messina 829, 95126 Catania, Italy; Faculty of Medicine of Tunis, University Tunis El Manar, Tunisia.
Heart Lung. 2015 Jul-Aug;44(4):309-13. doi: 10.1016/j.hrtlng.2015.03.005. Epub 2015 Apr 23.
We report our initial experience with extracorporeal membrane oxygenation (ECMO) use in elective high-risk complex percutaneous coronary intervention (PCI).
ECMO has been employed as hemodynamic support in patients with cardiac arrest and hemodynamic shock.
We performed a single-center prospectical study, enrolling all patients at very high-risk for coronary artery bypass grafting (CABG). Major adverse cardiac and cerebrovascular events (MACCE) were defined as a composite of death, acute myocardial infarction (MI), stroke and further need for revascularization.
Twelve patients underwent elective high-risk PCI with ECMO support (mean age = 63.5 ± 8.7 years). The mean SYNTAX score was 30.1 ± 10.1. All PCI procedures were successful and no in-hospital MACCE was observed. At 6-months, neither death nor MI was noticed. Two patients (17%) required further revascularization, and one patient required chronic hemodialysis.
Elective high-risk PCI supported by ECMO is a viable alternative for patients who are at very high risk for CABG.
我们报告了体外膜肺氧合（ECMO）用于择期高风险复杂经皮冠状动脉介入治疗（PCI）的初步经验。
ECMO已被用作心脏骤停和血流动力学休克患者的血流动力学支持。
我们进行了一项单中心前瞻性研究，纳入所有冠状动脉旁路移植术（CABG）极高风险患者。主要不良心脑血管事件（MACCE）定义为死亡、急性心肌梗死（MI）、中风以及进一步血运重建需求的综合情况。
12例患者在ECMO支持下接受了择期高风险PCI（平均年龄 = 63.5 ± 8.7岁）。平均SYNTAX评分为30.1 ± 10.1。所有PCI手术均成功，未观察到院内MACCE。6个月时，未发现死亡或MI。2例患者（17%）需要进一步血运重建，1例患者需要长期血液透析。
对于CABG极高风险患者，ECMO支持下的择期高风险PCI是一种可行的替代方案。
