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Short‐term mechanical circulatory support devices as bridge to heart transplantation: A prospective single‐center experience in Argentina
Author(s) -
Giordanino Elian F.,
Absi Daniel O.,
Favaloro Liliana E.,
Renedo Maria F.,
Ratto Roxana D.,
Rubira Daniela M.,
Ameri Aldana,
Giunta Gustavo,
Favaloro Roberto R.,
Bertolotti Alejandro M.
Publication year - 2020
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.13888
Subject(s) - medicine , cardiogenic shock , extracorporeal membrane oxygenation , heart transplantation , single center , surgery , transplantation , circulatory system , ventricular assist device , stroke (engine) , sepsis , prospective cohort study , shock (circulatory) , hemodynamics , thrombosis , cardiology , heart failure , myocardial infarction , mechanical engineering , engineering
Background Patients with cardiogenic shock may require hemodynamic stabilization with short‐term mechanical circulatory support devices (ST‐MCS) such as extracorporeal membrane oxygenation (ECMO) and centrifugal pump (CP) as bridge to transplantion (BTT). This study aimed to describe ECMO and CP during BTT and after heart transplant. Methods A cohort of patients on ECMO or CP as BTT between April 2006 and April 2018 in a single hospital. Results Thirty‐seven consecutive patients with ECMO (n = 14) or CP (n = 23) were included. Acute kidney injury was more prevalent during CP (28.6% vs 69.6%, P = .02). There were no differences in stroke, thrombosis, sepsis, or vasoplegia. Bleeding (0% vs 56.5%, P = .0003) and reoperation (0% vs 47.8%, P = .002) were more frequent in CP group as well as mortality (0 vs 7 [30.4%], P = .03). The remaining 30 patients (81.1%) underwent heart transplantation, without differences in primary graft dysfunction, vasoplegia, reoperation for bleeding, or hospital stay. Mortality was 23.3% at 30 days, similar in both groups, with no further deaths at median follow‐up of 44.2 months. Conclusions In patients with cardiogenic shock, ST‐MCS with ECMO or CP as BTT are a lifesaving approach allowing successful transplantation in the majority of cases, with good short‐ and long‐term survival.