Published online Jun 6, 2022. doi: 10.12998/wjcc.v10.i16.5266
Peer-review started: August 2, 2021
First decision: December 17, 2021
Revised: December 30, 2021
Accepted: April 2, 2022
Article in press: April 2, 2022
Published online: June 6, 2022
Venoarterial extracorporeal membrane oxygenation (VA-ECMO) offers hemodynamic support for patients undergoing high-risk percutaneous coronary interventions (PCIs). However, long-term outcomes associated with VA-ECMO have not previously been studied.
To explore long-term outcomes in high-risk cases undergoing PCI supported by VA-ECMO.
In the present observational cohort study, 61 patients who received VA-ECMO-supported high-risk PCI between April 2012 and January 2020 at the Sixth Medical Center of Chinese People’s Liberation Army General Hospital were enrolled. The endpoint characteristics such as all-cause mortality, repeated cardiovascular diseases, and cardiac death were examined.
Among 61 patients, three failed stent implantation due to chronic total occlusions with severely calcified lesions. One patient showed VA-ECMO intolerance because of high left ventricular afterload. PCI was successfully performed in 57 patients (93.4%). The in-hospital mortality was 23.0%, and the overall survival was 45.9%, with a median follow-up period of 38.6 (8.6-62.1) mo.
VA-ECMO can be used as a support in patients undergoing high-risk PCI as it is associated with favorable long-term patient survival.
Core Tip: High-risk percutaneous coronary intervention (PCI) can result in hemodynamic instability during the perioperative period and is associated with poor outcomes. Venoarterial extracorporeal membrane oxygenation (VA-ECMO) can provide hemodynamic support for patients who undergo high-risk PCI. The main role of VA-ECMO in high-risk PCI is to prevent profound hypotension or low cardiac output episodes and allow sufficient time to achieve optimal and complete revascularization. We present a single-center, observational cohort study of all patients undergoing high-risk PCI supported by VA-ECMO. PCI was successfully performed in 57 patients (93.4%). The in-hospital mortality was 23.0%. The overall survival was 45.9% with a median follow-up time of 38.6 (8.6-62.1) mo. VA-ECMO can be successfully used in patients undergoing high-risk PCI with good long-term survival.