A 20-year multicentre outcome analysis of salvage mechanical circulatory support for refractory cardiogenic shock after cardiac surgery

Khorsandi, Maziar; Dougherty, Scott; Sinclair, Andrew; Buchan, Keith; MacLennan, Fiona; Bouamra, Omar; Curry, Philip; Zamvar, Vipin; Berg, Geoffrey; Al-Attar, Nawwar

doi:10.1186/s13019-016-0545-5

Table 1 Patient baseline characteristics

From: A 20-year multicentre outcome analysis of salvage mechanical circulatory support for refractory cardiogenic shock after cardiac surgery

	Age & Gender	Date of surgery	Original operation	Duration and Mode of AMCS	AMCS Complication/s	Outcome
Patient 1	76 year old male	2012	Re-do sternotomy and AVR	Salvage peripheral VA ECMO due to postoperative pulmonary haemorrhage and cardiogenic shock	Femoral artery cannulation site pseudoaneurysm	Alive
					Femoral artery cannulation site pseudoaneurysm	NYHA I (No breathlessness of exertion, back to work)
					Major haemorrhage from cannulation site	NYHA I (No breathlessness of exertion, back to work)
Patient 2	40 year old male	2014	Re-do, Re-do sternotomy for type A aortic dissection: Bentall procedure	Salvage RVAD due to VF arrest and severe LVSD after weaning from CPB	Major haemorrhage and re-exploration in the operating theatre	Alive
Patient 2	40 year old male	2014				NYHA II (Breathless on exertion)
Patient 3	82 year old male	2006	MV Repair and CABG	3 Days	Could not be weaned from ECMO with severe biVent failure and	Died in CTICU
Patient 3	82 year old male	2006	MV Repair and CABG	VA ECMO as unable to wean from CPB		COD: BiVent failure
Patient 4	72 year old Female	2011	AVR	9 Days	Septic shock	Died in CTICU
Patient 4	72 year old Female	2011	AVR	VA ECMO as unable to come off CPB	Limb ischaemia	COD: Septic shock
Patient 5	71 year old male	2011	CABG and AVR	2 Days	ECMO cannulation site bleeding and haematoma explored	Died in CTICU
				Peripheral VA ECMO as unable to come off CPB	ECMO cannulation site bleeding and haematoma explored	COD: Shock (unknown cause)
				Peripheral VA ECMO as unable to come off CPB	Renal failure ^a	COD: Shock (unknown cause)
Patient 6	83 year old female	2012	MVR and CABG	<1 Day	None	Died in CTICU
Patient 6	83 year old female	2012	MVR and CABG	Peripheral VA ECMO as unable to wean from CPB	None	COD: BiVent failure
Patient 7	70 year old male	2013	Re-do sternotomy and AVR	33 Days	Major CVA	Died in HDU
Patient 7	70 year old male	2013	Re-do sternotomy and AVR	VA ECMO for cardiac failure. Successfully weaned from ECMO	Major CVA	COD: severe Respiratory failure
Patient 8	72 year old male	2013	Re-do sternotomy and AVR	<1 Day	ECMO cannulation femoral artery dissection	Died in CTICU
				VA ECMO after iatrogenic aortic dissection leading to cardiogenic shock during Femoral cannulation for CPB	ECMO cannulation femoral artery dissection	COD: Major CVA
					Major haemorrhage
					Major CVA
Patient 9	51 year old male	2013	Re-suspension of Aortic valve and repair of type A aortic dissection	1 Day	Major cannulation site haemorrhage	Died in CTICU
Patient 9	51 year old male	2013		Peripheral VA ECMO for cardiogenic shock	Major cannulation site haemorrhage	COD: Haemorrahgic shock and BiVent failure
Patient 10	34 year old female	2014	IVC Leiomyosarcoma resection	3 Days	None	Died in CTICU
Patient 10	34 year old female	2014	IVC Leiomyosarcoma resection	VA ECMO for postoperative cardiogenic shock for intraoperative MI	None	COD: BiVent failure from acute MI
Patient 11	65 year old male	2013	CABG	2 Days	Renal failure^a	Died in CTICU
				Salvage VA ECMO for cardiogenic shock	Hepatic failure	COD: MODS
				Salvage VA ECMO for cardiogenic shock	Pulmonary oedema	COD: MODS
Patient 12	71 year old male	2015	CABG	3 Days	Major haemorrhag e: Re-opening for bleeding x4	Died in CTICU
				VA ECMO as unable to wean from CPB	Major haemorrhag e: Re-opening for bleeding x4	COD: biventricular failure and septic shock
				VA ECMO as unable to wean from CPB	limb ischaemia	COD: biventricular failure and septic shock
Patient 13	49 year old male	1997	CABG	VA ECMO as unable to wean from CPB	Note recorded	Alive
						(Died 2004)
						NYHA II
Patient 14	69 year old male	2004	MVR and CABG for mitral valve IE	VA ECMO as unable to wean from CPB	CVA and seizures	Alive
Patient 14	69 year old male	2004	MVR and CABG for mitral valve IE	VA ECMO as unable to wean from CPB	Renal failure ^a	NYHA II
Patient 15	41 year old female	2005	Aortic transection and diaphragm rupture	VA ECMO	Not recorded	Alive
Patient 15	41 year old female	2005	Aortic transection and diaphragm rupture	VA ECMO	Not recorded	NYHA I
Patient 16	59 year old male	2006	Type A aortic dissection	2 Days	Not recorded	Died
Patient 16	59 year old male	2006	Type A aortic dissection	Peripheral VA ECMO as unable to wean from CPB	Not recorded	COD: Bivent failure
Patient 17	21 year old male	2014	AVR	3 days	ECMO cannulation site bleeding-required re-exploration	Alive
				Peripheral VA ECMO	ECMO cannulation site bleeding-required re-exploration	NYHA I
				Peripheral VA ECMO	Cardiac tamponade	NYHA I
Patient 18	51 year old male	2014	AVR	6 days	CVA and Seizures	Died in ICU
Patient 18	51 year old male	2014	AVR	Peripheral VA ECMO	limb ischaemia	COD: status epilepticus
Patient 19	46 year old male	2014	CABG	2 days	Major haemorrahage	Died in ICU
				Peripheral VA ECMO converted to central VA ECMO due to peripheral ischaemia	Major haemorrahage	COD: MODS
					Limb ischaemia/compartment syndrome-bilateral fasciotomies
					Renal failure^a
Patient 20	54 year old male	2015	CABG and AVR	3 days	SVT/VT	Alive
				VA ECMO for cardiogenic shock	Major intra-abdominal haemorrhage requiring laparotomy	NYHA II (Neuropathic leg pain)
				VA ECMO for cardiogenic shock	Limb ischaemia	NYHA II (Neuropathic leg pain)
Patient 21	56 year old male	2015	AVR	3 days	CVA (occipital infarcts)	Alive
Patient 21	56 year old male	2015	AVR	Peripheral VA ECMO for cardiogenic shock	CVA (occipital infarcts)	NYHA I (Visual difficulties)
Patient 22	64 year old male	2015	AVR	1 day	Vasoplegia	Died
Patient 22	64 year old male	2015	AVR	VA ECMO	MODS	COD: AV dissociation
Patient 23	52 year old male	2015	CABG	1 day	MODS	Died
Patient 23	52 year old male	2015	CABG	VA ECMO	MODS	COD: MODS
Patient 24	64 year old male	2015	AVR	7 days	None	Alive
Patient 24	64 year old male	2015	AVR	VA ECMO	None	NYHA I
Patient 25	50 year old male	2014	AVR	23 days	Renal failure^a	Alive
				BiVAD	Renal failure^a	NYHA I
				BiVAD	Haemothorax/mediastinal collection requiring re-operation	NYHA I
Patient 26	54 year old male	2015	Bentall’s procedure and CABG surgery	2 days	Hepatic failure	COD: MODS
Patient 26	54 year old male	2015	Bentall’s procedure and CABG surgery	LVAD acute LV failure	Renal failure please^a	COD: MODS
Patient 27	61 year old male	2003	CABG	11 days	Respiratory failure	Alive
Patient 27	61 year old male	2003	CABG	LVAD for acute LV failure	Renal failure^a	NYHA II

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
^aAll patients with renal failure required renal replacement therapy

Back to article page

ISSN: 1749-8090

Contact us

General enquiries: journalsubmissions@springernature.com

Journal of Cardiothoracic Surgery

Contact us