TY - JOUR
T1 - Impact of extra-corporeal life support (ECLS) cannulation strategy on outcome after durable mechanical circulation support system implantation on behalf of durable MCS after ECLS Study Group
AU - Saeed, Diyar
AU - Potapov, Evgenij
AU - Loforte, Antonio
AU - Morshuis, Michiel
AU - Schibilsky, David
AU - Zimpfer, Daniel
AU - Riebandt, Julia
AU - Pappalardo, Federico
AU - Attisani, Matteo
AU - Rinaldi, Mauro
AU - Pacini, Davide
AU - Haneya, Assad
AU - Ramjankhan, Faiz
AU - Donker, Dirk W.
AU - Jorde, Ulrich P.
AU - Otto, Wolfgang
AU - Stein, Julia
AU - Tsyganenko, Dmytro
AU - Al-Naamani, Ameen
AU - Wieloch, Radi
AU - Ayala, Rafael
AU - Cremer, Jochen
AU - Borger, Michael
AU - Lichtenberg, Artur
AU - Gummert, Jan
N1 - Publisher Copyright:
© 2021. Annals of Cardiothoracic Surgery. All Rights Reserved.
PY - 2021/5
Y1 - 2021/5
N2 - Background: The literature on outcomes of patients requiring durable mechanical circulatory support (MCS) after extra-corporeal life support (ECLS) is limited. The aim of this study was to investigate the impact of preoperative ECLS cannulation on postoperative outcome after durable MCS implantation. Methods: The durable MCS after ECLS registry is a multicenter retrospective study that gathered data on consecutive patients who underwent durable MCS implantation after ECLS between January 2010 and August 2018 in eleven high volume European centers. Patients who underwent the implantation of total artificial heart, pulsatile pumps, or first-generation pumps after ECLS were excluded from the analysis. The remaining patients were divided into two groups; central ECLS group (cECLS) and peripheral ECLS group (pECLS). A 1:1 propensity score analysis was performed to identify two matched groups. The outcome of these two groups was compared. Results: A total of 531 durable MCS after ECLS were implanted during this period. The ECLS cannulation site was peripheral in 87% (n=462) and central in 13% (n=69) of the patients. After excluding pulsatile pumps and total artificial heart patients, a total of 494 patients remained (pECLS =434 patients, cECLS =60 patients). A 1:1 propensity score analysis resulted in 2 matched groups (each 55 patients) with median age of 54 years (48-60 years) in cECLS group and 54 years (43-60 years) in pECLS group. HeartWare HVAD (Medtronic, Minneapolis, MN) was implanted in the majority of the patients (cECLS =71% vs. pECLS =76%, P=0.67). All postoperative morbidities were comparable between the groups. The thirty-day, one year and long-term survival was comparable between the groups (P=0.73). Conclusions: The cannulation strategy of ECLS appears to have no impact on the post-operative outcome after durable MCS implantation.
AB - Background: The literature on outcomes of patients requiring durable mechanical circulatory support (MCS) after extra-corporeal life support (ECLS) is limited. The aim of this study was to investigate the impact of preoperative ECLS cannulation on postoperative outcome after durable MCS implantation. Methods: The durable MCS after ECLS registry is a multicenter retrospective study that gathered data on consecutive patients who underwent durable MCS implantation after ECLS between January 2010 and August 2018 in eleven high volume European centers. Patients who underwent the implantation of total artificial heart, pulsatile pumps, or first-generation pumps after ECLS were excluded from the analysis. The remaining patients were divided into two groups; central ECLS group (cECLS) and peripheral ECLS group (pECLS). A 1:1 propensity score analysis was performed to identify two matched groups. The outcome of these two groups was compared. Results: A total of 531 durable MCS after ECLS were implanted during this period. The ECLS cannulation site was peripheral in 87% (n=462) and central in 13% (n=69) of the patients. After excluding pulsatile pumps and total artificial heart patients, a total of 494 patients remained (pECLS =434 patients, cECLS =60 patients). A 1:1 propensity score analysis resulted in 2 matched groups (each 55 patients) with median age of 54 years (48-60 years) in cECLS group and 54 years (43-60 years) in pECLS group. HeartWare HVAD (Medtronic, Minneapolis, MN) was implanted in the majority of the patients (cECLS =71% vs. pECLS =76%, P=0.67). All postoperative morbidities were comparable between the groups. The thirty-day, one year and long-term survival was comparable between the groups (P=0.73). Conclusions: The cannulation strategy of ECLS appears to have no impact on the post-operative outcome after durable MCS implantation.
KW - Mechanical circulatory support (MCS)
KW - cannulation strategy
KW - extra-corporeal life support (ECLS)
KW - outcome
KW - ventricular assist device
UR - http://www.scopus.com/inward/record.url?scp=85107763911&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85107763911&partnerID=8YFLogxK
U2 - 10.21037/acs-2020-cfmcs-251
DO - 10.21037/acs-2020-cfmcs-251
M3 - Article
AN - SCOPUS:85107763911
SN - 2225-319X
VL - 10
SP - 353
EP - 363
JO - Annals of Cardiothoracic Surgery
JF - Annals of Cardiothoracic Surgery
IS - 3
ER -