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Isolated left ventricular failure is a predictor of poor outcome in patients receiving veno‐arterial extracorporeal membrane oxygenation
Author(s) -
den Uil Corstiaan A.,
Jewbali Lucia S.,
Heeren Martijn J.,
Constantinescu Alina A.,
Van Mieghem Nicolas M.,
Reis Miranda Dinis dos
Publication year - 2017
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1002/ejhf.853
Subject(s) - medicine , heart failure , cardiogenic shock , cardiology , extracorporeal membrane oxygenation , myocardial infarction
Aims We investigated survival according to the nature of heart failure (isolated left, vs isolated right, vs biventricular heart failure) in patients undergoing extracorporeal membrane oxygenation ( ECMO ) for refractory cardiogenic shock of different causes. Methods and results This single‐center study included 132 patients with acute myocardial infarction (20%), acute on chronic heart failure (14%), post cardiotomy (17%), cardiac allograft failure (8%), pulmonary embolism (16%), and acute nonischemic heart failure (25%). Ventricular function was a priori assessed by transthoracic echocardiography (isolated left (26%), isolated right (22%), or biventricular heart failure (52%)). The primary endpoint was all‐cause mortality at 90 days and long‐term. Predictors for adverse outcome were identified by univariate and multivariate Cox regression analysis. Median duration of ECMO support was 6 [3–9] days. Ninety‐day survival was 51% (isolated LV failure 32% vs. isolated RV failure 62% vs. biventricular failure 55%, p = 0.04). The presence of isolated left ventricular failure was a predictor for 90‐day mortality, irrespective of diagnosis and SAVE score. In patients who survived 90 days following ECMO implantation, long‐term (4‐year) survival was excellent (95%, no difference between subgroups). Conclusion Isolated left ventricular failure was an independent predictor for 90‐day outcome.