Table 3 ECLS subgroup analysis
From: Coronary artery bypass grafting in young patients - insights into a distinct entity
Patient | Presentation | Indication for ECLS | ECLS support | Surgery | Postoperative course | Outcome |
|---|---|---|---|---|---|---|
1 | NSTEMI, CA: Bifurcation stenosis of LAD/D1 | difficult weaning from CPB | d0-d2 | LIMA-LAD,-D1 | ECMO explanation D3, uneventful postoperative course | LV-EF at discharge 50% |
2 | Present to referring hospital with angina, CA: RCA 100%, CX: procimal 90%, LAD; 100%, unsuccessful attempt for PTCA/Stentimplantation of the CX with iatrogenic dissection, rescue attempt with ReoPro, CPR during postoperative course, operation the same day as admission to primary hospital | difficult weaning from CPB under running IABP, ECLS intraoperativly | d0-d9 | ACVB-LAD, ACVB-PLA1-PLA3, RIVP | dialysis during postoperative course, recovered POD 17, prolonged ventilation with tracheotomy, removed POD 23, Re-Thoracotomy POD 1, POD 12 due to haematothorax with pericardial tamponade | LV-EF POD 1: 20% under ECLS support), LV-EF prior to discharge: 50% |
3 | STEMI, CA: LAD 100% proximal, CX, PLA 1 90%, RCA 100%, Patient in cardiogenic shock with unstable hameodynamic under catecholamines, immediate referral to OR | cardiogenic shock, difficult weaning from CPB under IABP support | d0-d12 | LIMA-LAD, ACVB-RIVP-PLA | dialysis during postoperative course, recovery day 14, | LV-EF POD 1 under ECLS 25%, LV-EF prior to discharge 35% |
4 | Unstable angina, CA: LAD 90%, Cx 100%, RCA 100%, cardiac decompensation with peripheral oedema and septic ulcers, multiple sclerosis, severe obesity | cardiogenic shock, difficult weaning from CPB under IABP support | d0-d7 | LIMA-LAD-D1, radial artery PLA-RIVP (septic ulcers, no vein grafts available) | Dialysis during postoperative course, compartment syndrome left lower leg, re-thoracotomy due to tamponade, septic shock | death POD 7 |
5 | presentation with beginning cardiac decompensation and respiratory insufficiency, CA: LAD 100%, Cx 90, RCA 90%, ECLS support in reffering hospital prior to transport, Echo: LV-EF 45%, MI III (rupture of posteromedian papillary muscle) | cardiogenic shock | d-1-d4 | MVR (SJM, 29 mm), ACVB-LAD, ACVB-PLA1-RIVP | Dialysis during postoperative course, recovered POD 5, short CPR on POD 5, ICD implantation POD 30 | LV-EF at discharge 65% mechanical prosthesis in mitral position with no PVL and normal function |
6 | Angina and Dyspnoea in referring hospital, CA: LAD 40%, PLA 2 90%, RIVP 70%, MI III | difficult weaning from CPB, ECLS intraoperativly | d0-d8 | MVR (anuloplasty with ring), ACVB-PLA-RIVP | Dialysis once (POD 1), prolonged ventilation with tracheotomy until POD 27 | LV-EF prior to discharge 40% |