Extracorporeal membrane oxygenation for post-aortic surgery: A retrospective study in a single center
- VernacularTitle:主动脉手术后体外膜肺氧合支持的单中心回顾性研究
- Author:
Shujie YAN
1
;
Chun ZHOU
1
;
Gang LIU
1
;
Sizhe GAO
1
;
Jiachen QI
1
;
Cuntao YU
2
;
Zujun CHEN
3
;
Bingyang JI
1
;
Song LOU
1
Author Information
1. Department of Extracorporeal Circulation, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, P. R. China
2. Department of Vascular Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, P. R. China
3. Department of Surgical ICU, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, P. R. China
- Publication Type:Journal Article
- Keywords:
Aortic dissection;
extracorporeal membrane oxygenation;
aortic surgery
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2024;31(05):751-756
- CountryChina
- Language:Chinese
-
Abstract:
Objective To describe the outcomes of extracorporeal membrane oxygenation (ECMO) for patients after aortic surgery and to summarize the experience. Methods The clinical data of patients who received ECMO support after aortic surgery in Fuwai Hospital from 2009 to 2020 were retrospectively analyzed. The patients who received an aortic dissection surgery were allocated into a dissection group, and the other patients were allocated into a non-dissection group. The in-hospital and follow-up survival rates were compared between the two groups, and the causes of death were analyzed. Results A total of 22 patients were enrolled, including 17 patients in the dissection group [13 males and 4 females, with a median age of 54 (46, 61) years] and 5 patients in the non-dissection group [3 males and 2 females, with a median age of 51 (41, 65) years]. There was no statistical difference in the age and gender between the two groups (P>0.05). The in-hospital survival rate (11.8% vs. 100.0%, P=0.001) and follow-up survival rate (11.8% vs. 80.0%, P=0.009) of the patients in the dissection group were significantly lower than those in the non-dissection group. The causes of death in the dissection group included massive bleeding and disseminated intravascular coagulation (3 patients), ventricular thrombosis (1 patient), irreversible brain injury (2 patients), visceral malperfusion syndrome (4 patients) and irreversible heart failure (5 patients). Conclusion ECMO after aortic dissection surgery is associated with high mortality, which is related to the pathological features of aortic dissection and severely disrupted coagulation system after the surgery. For these patients, strict indication selection and optimal management strategy are important.
