Korean J Thorac Cardiovasc Surg.
2011 Aug;44(4):273-278. 10.5090/kjtcs.2011.44.4.273.
Results of Extracorporeal Membrane Oxygenation (ECMO) Support before Coronary Reperfusion in Cardiogenic Shock with Acute Myocardial Infarction
- Affiliations
-
- 1Department of Thoracic and Cardiovascular Surgery, Sanggye Paik Hospital, Inje University, Korea.
- 2Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Korea. mluemoon@snubh.org
- 3Department of Thoracic and Cardiovascular Surgery, Kosin University Gospel Hospital, Korea.
- 4Department of Thoracic and Cardiovascular Surgery, Eulji University Hospital, Korea.
- 5Department of Thoracic and Cardiovascular Surgery, Seoul Metropolitan Boramae Hospital, Seoul National University, Korea.
- KMID: 1447722
- DOI: http://doi.org/10.5090/kjtcs.2011.44.4.273
Abstract
- BACKGROUND
Despite aggressive treatment, the mortality rate of cardiogenic shock with acute myocardial infarction (AMI) is high. We performed extracorporeal membrane oxygenation (ECMO) prior to coronary reperfusion, and evaluated the early clinical results and risk factors.
MATERIALS AND METHODS
From May 2006 to November 2009, we reviewed the medical records of 20 patients in cardiogenic shock with AMI (mean age 67.7+/-11.7 yrs, M : F 14 : 6). After initially performing ECMO using the CAPIOX emergency bypass system (EBS(R)Terumo, Tokyo, Japan), patients underwent coronary reperfusion (coronary artery bypass grafting, 13; percutaneous coronary intervention, 7).
RESULTS
All patients were in a cardiogenic shock state, cardiopulmonary resuscitations (CPR) were performed for fourteen patients (mean CPR time 20.8+/-26.0 min). The mean time from vascular access to the initiation of ECMO was 17.2+/-9.4 min and mean support time was 3.8+/-4.0 days. Fourteen patients were able to be weaned from ECMO and ten patients were discharged (mean admission duration 50.1+/-31.6 days). Patients survived on average 476.6+/-374.6 days of follow-up. Longer CPR and support time, increased cardiac enzyme, lower ejection fraction, lower albumin, and major complications were the risk factors of mortality (p<0.05).
CONCLUSION
The early application of ECMO prior to coronary reperfusion and control of risk factors allowed for good clinical results in cardiogenic shock with AMI.
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