PERIPHERAL VENO-ARTERIAL ECMO AS MECHANICAL CIRCULATORY SUPPORT BEFORE HEART TRANSPLANTATION
https://doi.org/10.15825/1995-1191-2013-2-23-35
Abstract
Aim of our clinical study was evaluation own initial experience of high-urgency ortotopic heart transplantation (OHT) in recipients, who were bridged on peripheral Vena-Arterial Extracorporeal Membrane Oxygenation (VA ECMO).
Materials and methods. In this study was included 17 patients (14/3 M/F, age 16–66 (40.1 ±
4.2 yrs)) who underwent OHT while on peripheral ECMO support. In all cases we used peripheral surgical can- nulation technique via femoral vessels – arterial cannula 15–19 Fr, venous cannula – 21–25 Fr, arterial cannula or vascular catheter 8–10 Fr for anterograde leg’s perfusion.
Results. Duration Vena-Arterial Extracorporeal Membrane Oxygenation before OHT was 81 ± 17 h. VA ECMO support was blood flow 4.8 ± 0.6 l/min or 2.63 ± 0/04 l/min/m2, gas flow 4.8 ± 0.6 l/min, FiO2 0.86 ± 0.07. Vena-Arterial Extracorporeal Membrane Oxygenation support was continued in “protective mode” (blood flow 1.9 ± 0.2 l/min) 4.3 ± 0.5 days after OHT. Thirteen pa- tients (76.4%) were weaned from VA ECMO successfully and survived to be discharged. ICU and hospital LOS after orthotopic heart transplantation was respectively 6.7 ± 0.8 and 32.3 ± 4.6 days in group of survived patients. The reasons of a lethal outcome (n = 4, 23.5%) were sepsis and multiorgan failure (n = 3), sudden cardiac arrest (n = 1).
Conclusion. Vena-Arterial Extracorporeal Membrane Oxygenation is a favorable short-term method of circulatory support in patients who needed in high-urgency heart transplantation.
About the Authors
E. A. Spirina
Academician V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs (Head – academician of RAMSci, prof. S.V. Gautier), Moscow, Russian Federation
R. S. Saitgareev
Academician V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs (Head – academician of RAMSci, prof. S.V. Gautier), Moscow, Russian Federation
D. V. Shumakov
Academician V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs (Head – academician of RAMSci, prof. S.V. Gautier), Moscow, Russian Federation
V. M. Zakharevitch
Academician V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs (Head – academician of RAMSci, prof. S.V. Gautier), Moscow, Russian Federation
I.M. Sechenov First Moscow State Medical University (Rector – corresponding member of RAMSci,
prof. P.V. Glybochko), Department of Tansplantology and Artificial organs (Head – academician
of RAMSci, prof. S.V. Gautier), Moscow, Russian Federation
V. V. Slobodyannik
Academician V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs (Head – academician of RAMSci, prof. S.V. Gautier), Moscow, Russian Federation
M. G. Minina
Coordinator Centre of Organ’s Donation, Department of Health (Head – cand. of sci M.G. Minina), Moscow, Russian Federation
V. V. Pchelnikov
Academician V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs (Head – academician of RAMSci, prof. S.V. Gautier), Moscow, Russian Federation
O. A. Eremeeva
Academician V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs (Head – academician of RAMSci, prof. S.V. Gautier), Moscow, Russian Federation
P. G. Lavrenov
Academician V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs (Head – academician of RAMSci, prof. S.V. Gautier), Moscow, Russian Federation
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Review
For citations:
Spirina E.A., Saitgareev R.S., Shumakov D.V., Zakharevitch V.M., Slobodyannik V.V., Minina M.G., Pchelnikov V.V., Eremeeva O.A., Lavrenov P.G. PERIPHERAL VENO-ARTERIAL ECMO AS MECHANICAL CIRCULATORY SUPPORT BEFORE HEART TRANSPLANTATION. Russian Journal of Transplantology and Artificial Organs. 2013;15(2):23-35. (In Russ.) https://doi.org/10.15825/1995-1191-2013-2-23-35
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