• Satoshi Unosawa, Akira Sezai, Mitsumasa Hata, Kinichi Nakata, Isamu Yoshitake, Shinji Wakui, Haruka Kimura, Kana Takahashi, Hiroaki Hata, and Motomi Shiono.
• Department of Cardiovascular Surgery, Nihon University School of Medicine, 30-1 Ooyaguchi-kami-machi, Itabashi-ku, Tokyo, 173-8610, Japan. unosaw@gmail.com
• Surg. Today. 2013 Mar 1;43(3):264-70.

PurposePostcardiotomy cardiogenic shock is still associated with a poor prognosis. We reviewed patients undergoing extracorporeal membrane oxygenation (ECMO) support for postcardiotomy cardiogenic shock and assessed their long-term outcomes.MethodsThe subjects were 47 patients who received ECMO support for cardiogenic shock after open heart surgery. We analyzed the long-term survival and risk factors for early or late death.ResultsTwenty-nine patients were weaned off ECMO support, but 15 of these patients died during their hospital stay. An independent predictor of mortality during ECMO support was incomplete sternum closure (OR 4.089, 95 % CL 1.003-16.67, p = 0.049) and a predictor of mortality after weaning off ECMO was more than 48 h of support (OR 8.975, 95 % CL 1.281-62.896, p = 0.027). Fourteen patients were discharged from hospital, but seven of these patients died during the follow-up period owing to cardiac events (n = 2) or non-cardiac causes (n = 5). The actuarial survival rates were 34.0 % at 30 days, 29.8 % at 1 year, and 17.6 % at 10 years.ConclusionAlthough postcardiotomy cardiogenic shock requiring ECMO support is associated with high morbidity and mortality, the long-term survival rate is acceptable.

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