• Loic Belle, Lionel Mangin, Henry Bonnet, Stephane Fol, Charles Santré, Laurence Delavenat, Dominique Savary, David Bougon, Emmanuelle Vialle, Antoine Dompnier, Emmanuel Desjoyaux, and Dominique Blin.
• Cardiology Department, Annecy Hospital, 1 avenue de l'Hopital, Metz-Tessy, France. loic.belle@wanadoo.fr
• EuroIntervention. 2012 Jul 20; 8 (3): 375-82.

AimsWe report the feasibility and outcomes of emergency extracorporeal membrane oxygenation (ECMO) implantation by a cardiac catheterisation team in patients in severe cardiogenic shock or refractory cardiac arrest in a hospital without cardiac surgical facilities.Methods And ResultsThis prospective cohort study involved 51 consecutive patients who had ECMO implantation (September 2006 - September 2010). Twenty-seven were in severe cardiogenic shock and 24 in refractory cardiac arrest (17 with out-of-hospital cardiac arrest; seven with in-hospital cardiac arrest). Implantations were done via a percutaneous femoral approach by a local interventional cardiologist team, and in collaboration with the nearest cardiac surgical institution. Patients' mean age was 51±15 years; 38 (74.5%) were men. Stable ECMO implantation was achieved in 26/27 (96.3%) patients in severe cardiogenic shock and in 18/24 (75.0%) patients in refractory cardiac arrest. In-hospital complications occurred in 23/27 cardiogenic shock patients; 13/27 were discharged alive. In patients with refractory cardiac arrest, complications occurred in 20/24; 21/24 were disconnected from ECMO because of brain death or multiorgan failure occurring ≤24 hours; one patient was discharged alive.ConclusionsEmergency ECMO implantation by an interventional cardiologist in a hospital without cardiac surgical facilities is feasible, with a failure rate concordant with the literature.

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