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Table 1 Illustrates patient characteristics, the type of mechanical circulatory support and outcomes over the 11-year study period

From: Advanced mechanical circulatory support for post-cardiotomy cardiogenic shock: a 20-year outcome analysis in a non-transplant unit

  Age & gender Co-morbidities & logistic euroSCORE Date of surgery Original operation Duration and mode of AMCS AMCS complication/s Outcome
Patient 1 76 year old male MI 2012 Re-do sternotomy and AVR Salvage peripheral VA ECMO due to postoperative pulmonary haemorrhage Femoral artery cannulation site pseudoaneurysm Alive
CABG
Moderate LVSD Major haemorrhage from cannulation site NYHA I (No breathlessness of exertion, back to work)
Hypertension
Hypercholestrolaemia
ICD for VF
CVA
EuroSCORE = 27.48
Patient 2 40 year old male MV repair 2014 Re-do, Re-do sternotomy for type A aortic dissection: Bentall procedure. Salvage RVAD due to VF arrest and asystolic LV after CPB Major haemorrhage and re-exploration in the operating theatre Alive
MVR
NYHA II (Breathless on exertion)
Moderate LVSD
Marfan’s syndrome
AF
LogEuroSCORE = 29.18
Patient 3 82 year old male Severe LVSD 2006 MV Repair and CABG 3 Days Could not be weaned from ECMO with severe biVent failure Died in CTICU
MI VA ECMO as unable to wean from CPB COD: BiVent failure
Severe TVD
LogEuroSCORE = 17.45
Patient 4 72 year old Female Good LV function 2011 AVR 9 Days Septic shock Died in CTICU
Moderate MR VA ECMO as unable to come off CPB Peripheral ischaemia COD: Septic shock
EuroSCORE = 12.11
Patient 5 71 year old male Urgent/Emergency Surgery 2011 CABGx3 and AVR 2 Days ECMO cannulation site bleeding and haematoma explored Died in CTICU
Peripheral VA ECMO as unable to come off CPB Renal failurea COD: Shock (unknown cause)
MI (< 90 days)
Severe LVSD
Severe TVD
Anaemia
LogEuroSCORE = 26.35
Patient 6 83 year old female Urgent/Emergency Surgery 2012 MVR and CABG ×1 < 1 Day None Died in CTICU
Peripheral VA ECMO as unable to come off bypass and awaited family to see patient last time COD: BiVent failure
MI (< 90 days)
Severe LVSD
Acute severe MR
Cardiogenic shock
LogEuroSCORE = 73.26
Patient 7 70 year old male MI 2013 Re-do sternotomy and AVR 33 Days Major CVA Died in HDU
CABG VA ECMO. Successfully weaned from ECMO COD: severe Respiratory failure
CVA
Hypertension
Hypercholestrolaemia
Good LV
LogEuroSCORE = 14.31
Patient 8 72 year old male Moderate LVSD 2013 Re-do sternotomy and AVR < 1 Day ECMO cannulation femoral artery dissection Died in CTICU
CABG
Atrial flutter VA ECMO after iatrogenic aortic dissection during Femoral cannulation for bypass Major haemorrhage COD: Major CVA
Hypertension
LogEuroSCORE = 13.09 Major CVA
Patient 9 51 year old male Moderate LVSD 2013 Re-suspension of Aortic valve and repair of type A aortic dissection 1 Day Major cannulation site haemorrhage Died in CTICU
LogEuroSCORE = 13.13 Peripheral VA ECMO COD: Haemorrahgic shock and BiVent failure
Patient 10 34 year old female Good LV 2014 IVC Leiomyosarcoma resection 3 Days None Died in CTICU
LogEuroSCORE = 2.08 VA ECMO COD: BiVent failure from acute MI
Patient 11 65 year old male Urgent surgery 2013 CABG 2 Days Renal failurea Died in CTICU
ACS (Unstable angina) Salvage VA ECMO Hepatic failure COD: MODS
LogEuroSCORE = 4.55 Pulmonary oedema
Patient 12 71 year old male Peripheral vasculopath 2015 CABG 3 Days Major haemorrhage: Re-opening for bleeding ×4 Died in CTICU
LogEuroSCORE = 3.67
VA ECMO as unable to wean from CPB Peripheral leg ischaemia COD: biventricular failure and septic shock
Patient 13 49 year old male Emergency Surgery 1997 CABG VA ECMO Note recorded Alive (Died 2004) NYHA II
PVD
Intra-operative MI
LogEuroSCORE = 5.69
Patient 14 69 year old male Active IE 2004 MVR and CABG for mitral valve IE VA ECMO CVA and seizures Renal failurea Alive NYHA II
Emergency surgery
Moderate LVSD
LogEuroSCORE = 21.73
Patient 15 41 year old female Emergency surgery 2005 Aortic transection and diaphragmatic rupture VA ECMO Not recorded Alive NYHA I
Good LV
LogEuroSCORE = 25.50
Patient 16 59 year old male MI (< 90 days) 2006 Type A aortic dissection 2 Days Not recorded Died COD: Bivent failure
Severe LVSD Peripheral VA ECMO as unable to come off bypass
Emergency surgery
LogEuroSCORE = 33.90
  1. Abbreviations: ACS acute coronary syndrome, AF atrial fibrillation, AMCS advanced mechanical circulatory support, AVR aortic valve replacement, CABG coronary artery bypass grafting surgery, CPB cardiopulmonary bypass, COD cause of death, BiVent failure biventricular failure, MVR mitral valve replacement, IE infective endocarditis, CVA cerebrovascular accident, IVC, inferior vena-cava, NYHA New York Heart Association, CTICU cardiothoracic intensive care unit, HDU high dependency unit, implantable cardioverter defibrillator, MI myocardial infarction, LVSD left ventricular systolic dysfunction, TVD triple vessel coronary artery disease, LV left ventricular, MR mitral regurgitation, PVD peripheral vascular disease, MODS multi-organ dysfunction syndrome, VF ventricular fibrillation, VAD ventricular assist device, VA veno-arterial;
  2. aAll patients with renal failure required renal replacement therapy
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Journal of Cardiothoracic Surgery

ISSN: 1749-8090

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