Baran Cagdas, Ozcinar Evren, Kayan Ahmet, Saricaoglu Mehmet Cahit, Hasde Ali Ihsan, Baran Canan Soykan, Akar Ahmet Ruchan, Eryilmaz Sadik
Department of Cardiovascular Surgery, Heart Center, Cebeci Hospitals, Ankara University School of Medicine, 06230 Ankara, Turkey.
Department of Cardiovascular Surgery, Kirikkale High Specialization Hospital, 71300 Kirikkale, Turkey.
J Clin Med. 2024 Aug 26;13(17):5055. doi: 10.3390/jcm13175055.
This study assessed vascular complications in patients who received extracorporeal membrane support following cardiac surgery. We included 84 post-cardiotomy patients who underwent extracorporeal membrane oxygenation (ECMO) from July 2018 to May 2022. Only patients connected to VA-ECMO (Veno-Arterial) via peripheral cannulation were included in this study. Vascular complications were compared between those who had ECMO placed using the percutaneous technique ( = 52) and those who had it placed via femoral incision ( = 32). The incidence of vascular thromboembolism was significantly higher in the percutaneous technique group compared with the open technique group ( < 0.05). Hematomas were also more frequent in the percutaneous technique group ( = 0.04). Conversely, bleeding and leakage were significantly more frequent in the open technique group ( = 0.04). There were no significant differences between the two groups in terms of wound infections or revisions in the inguinal area following ECMO removal. The mortality rate associated with vascular ischemia was 81.2%, while the overall in-hospital mortality rate was 60.7%. The open technique for ECMO placement may reduce the risk of thromboembolic events and hematomas compared to the percutaneous technique. However, it may be associated with a higher incidence of bleeding and leakage. Both techniques show similar outcomes in terms of overall mortality and wound infections.
本研究评估了心脏手术后接受体外膜肺氧合支持的患者的血管并发症。我们纳入了2018年7月至2022年5月期间接受体外膜肺氧合(ECMO)的84例心脏术后患者。本研究仅纳入通过外周插管连接至VA-ECMO(静脉-动脉)的患者。比较了采用经皮技术置入ECMO的患者(n = 52)和经股切口置入ECMO的患者(n = 32)的血管并发症。与开放技术组相比,经皮技术组的血管血栓栓塞发生率显著更高(P < 0.05)。经皮技术组的血肿也更常见(P = 0.04)。相反,开放技术组的出血和渗漏明显更常见(P = 0.04)。两组在伤口感染或ECMO撤除后腹股沟区域的翻修方面无显著差异。与血管缺血相关的死亡率为81.2%,而总体住院死亡率为60.7%。与经皮技术相比,ECMO置入的开放技术可能会降低血栓栓塞事件和血肿的风险。然而,它可能与更高的出血和渗漏发生率相关。两种技术在总体死亡率和伤口感染方面显示出相似的结果。