• Ta-Wei Su, Yuan-His Tseng, Tzu-I Wu, Pyng-Jing Lin, and Meng-Yu Wu.
• From the *Department of Cardiovascular Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan; †Department of Obstetrics and Gynecology, Wan Fang Hospital and Taipei Medical University, Taipei; and ‡Department of Medicine, Taipei Medical University, Taipei, Taiwan, R.O.C.
• ASAIO J. 2014 Nov 1; 60 (6): 664-9.

AbstractVenoarterial extracorporeal life support (VA-ECLS) is a lifesaving circulatory support in hemodynamic collapse induced by miscellaneous etiologies. However, survival rates vary among etiologies. To investigate the therapeutic effectiveness of VA-ECLS in hemodynamic collapse induced by fulminant cardiomyopathy (CM), a retrospective chart review of 14 patients was conducted, among the 294 adults receiving VA-ECLS in a single institution from April 2006 to April 2013. All patients received echocardiography, coronary angiography, or computed tomography before or immediately after undergoing VA-ECLS to exclude anatomic cardiac diseases. Myocarditis (n = 12) and peripartum CM (n = 2) were the subcategories of fulminant CM. The median door-to-ECLS duration was 12 hours. Seven patients received cardiopulmonary resuscitation (CPR) before VA-ECLS, and three required ECLS-assisted CPR to regain circulation. Two patients were transplanted as a result of myocardial irreversibility and one survived. Nine of the nontransplant patients survived after a median VA-ECLS of 167 hours. All of the 10 survivors, including the five experiencing dialysis-dependent acute renal failure, had their cardiac and renal function return to normal within 6 months after the episode. The VA-ECLS was a practical therapeutic option in fulminant CM. It could provide expeditious hemodynamic support and preserve organ viability essential to recovery.

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