• Heart Lung · Sep 2016

    Survival, quality of life and impact of right heart failure in patients with acute cardiogenic shock treated with ECMO.

    • Felix Schoenrath, Dennis Hoch, Francesco Maisano, Christoph T Starck, Burkhardt Seifert, Urs Wenger, Frank Ruschitzka, and Markus J Wilhelm.
    • Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353 Berlin, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Germany. Electronic address: schoenrath@dhzb.de.
    • Heart Lung. 2016 Sep 1; 45 (5): 409-15.

    BackgroundMechanical circulatory support is increasingly used in acute cardiogenic shock.ObjectiveTo assess treatment strategies for cardiogenic shock.MethodsData of 57 patients in acute intrinsic cardiogenic shock treated with ECMO were analyzed. Different subsequent strategies (weaning, VAD, transplantation) were followed.​ResultsOverall 1, 2, and 4-year survival was 36.8 ± 6.4%, 32.2 ± 6.4%, 29.8 ± 6.3%. Elevated lactate and hemorrhagic complications (all p in patients with right heart failure prior to ECMO implantation, BVAD therapy showed a trend (p=0.058) towards superior survival compared with LVAD therapy. Seven of the BVAD patients received successful transplantation, with a 1-year survival of 71%. Among survivors Short Form 36 reported significantly lower combined physical scores (p=0.004).ConclusionsRight heart assessment prior to ECMO implantation may be beneficial to provide tailored therapy if ECMO weaning fails. Survival after cardiogenic shock requiring ECMO seems to be associated with impaired long-term quality of life.Copyright © 2016 Elsevier Inc. All rights reserved.

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