Baran Cagdas, Ozcinar Evren, Kayan Ahmet, Dikmen Nur, Baran Canan Soykan, Inan Mustafa Bahadir
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 Cardiovasc Dev Dis. 2024 Sep 8;11(9):283. doi: 10.3390/jcdd11090283.
: This study aims to assess the outcomes and complications of patients who received veno-arterial extracorporeal membrane oxygenation (VA-ECMO) and intra-aortic balloon pump (IABP) support after cardiac surgery at Ankara University Heart Center between 2000 and 2023. : We have carried out a retrospective analysis that included 255 patients. Among them, 98 received IABP, 103 received VA-ECMO, and 54 received both VA-ECMO and IABP. Preoperative and postoperative assessments were carried out, including evaluations of left ventricular function and serum creatinine levels. Primary outcomes included 30-day survival and successful VA-ECMO weaning. Complications such as bleeding, sepsis, liver failure, wound infection, and peripheral ischemia were also assessed. : The weaning rate from VA-ECMO was significantly higher in the combined VA-ECMO and IABP group (81.4%) compared with the other groups ( = 0.004). One-year survival was also higher in the combined group (75.9%) ( = 0.002). Complications or renal function did not differ significantly among the groups. The primary indication for mechanical support was coronary artery bypass grafting. : In conclusion, the combined use of VA-ECMO and IABP therapy led to improved weaning and survival rates without increasing the risk of complications. These findings suggest that a combined approach may be beneficial for selected patients with severe cardiac dysfunction post surgery.
本研究旨在评估2000年至2023年期间在安卡拉大学心脏中心接受心脏手术后接受静脉-动脉体外膜肺氧合（VA-ECMO）和主动脉内球囊反搏（IABP）支持的患者的结局和并发症。我们进行了一项回顾性分析，纳入了255例患者。其中，98例接受了IABP，103例接受了VA-ECMO，54例同时接受了VA-ECMO和IABP。进行了术前和术后评估，包括左心室功能和血清肌酐水平的评估。主要结局包括30天生存率和成功撤离VA-ECMO。还评估了出血、败血症、肝衰竭、伤口感染和外周缺血等并发症。与其他组相比，VA-ECMO和IABP联合组的VA-ECMO撤离率显著更高（81.4%）（P = 0.004）。联合组的一年生存率也更高（75.9%）（P = 0.002）。各组之间并发症或肾功能无显著差异。机械支持的主要指征是冠状动脉旁路移植术。总之，VA-ECMO和IABP联合治疗可提高撤离率和生存率，而不增加并发症风险。这些发现表明，联合治疗方法可能对选定的术后严重心功能不全患者有益。
