Systematic Reviews
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Crit Care Med. Dec 20, 2019; 8(8): 135-147
Published online Dec 20, 2019. doi: 10.5492/wjccm.v8.i8.135
Extra-corporeal membrane oxygenation in aortic surgery and dissection: A systematic review
Massimo Capoccia, Marc O Maybauer
Massimo Capoccia, Department of Aortic and Cardiac Surgery, Royal Brompton Hospital, Royal Brompton and Harefield NHS Foundation Trust, London SW3 6NP, United Kingdom
Marc O Maybauer, Department of Anaesthesia, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester M13 9WL, United Kingdom
Marc O Maybauer, Department of Anaesthesiology and Intensive Care Medicine, Phillips University, Marburg 35037, Germany
Marc O Maybauer, Critical Care Research Group, The Prince Charles Hospital and The University of Queensland, Brisbane QLD 4032, Queensland, Australia
Marc O Maybauer, Advanced Critical Care and Transplant Institute, Integris Baptist Medical Centre, Oklahoma City, OK 73112, United States
Author contributions: Capoccia M and Maybauer MO contributed equally to the work; Capoccia M and Maybauer MO conceptualized and designed the review; Capoccia M and Maybauer MO carried out the analysis; Capoccia M drafted the initial manuscript; Capoccia M and Maybauer MO reviewed and approved the submitted manuscript.
Conflict-of-interest statement: The authors declare no conflict of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Massimo Capoccia, MD, MSc, Surgeon, Senior Aortic Fellow, Department of Aortic and Cardiac Surgery, Royal Brompton Hospital, Royal Brompton and Harefield NHS Foundation Trust, Sydney Street, Chelsea, London SW3 6NP, United Kingdom. capoccia@doctors.org.uk
Telephone: +44-20-73528121
Received: October 15, 2019
Peer-review started: October 15, 2019
First decision: October 25, 2019
Revised: November 28, 2019
Accepted: November 28, 2019
Article in press: November 28, 2019
Published online: December 20, 2019
Abstract
BACKGROUND

Very little is known about the role of extracorporeal membrane oxygenation (ECMO) for the management of patients undergoing major aortic surgery with particular reference to aortic dissection.

AIM

To review the available literature to determine if there was any evidence.

METHODS

A systematic literature search through PubMed and EMBASE was undertaken according to specific key words.

RESULTS

The search resulted in 29 publications relevant to the subject: 1 brief communication, 1 surgical technique report, 1 invited commentary, 1 retrospective case review, 1 observational study, 4 retrospective reviews, 13 case reports and 7 conference abstracts. A total of 194 patients were included in these publications of whom 77 survived.

CONCLUSION

Although there is no compelling evidence for or against the use of ECMO in major aortic surgery or dissection, it is enough to justify its use in this patient population despite current adverse attitude.

Keywords: Aortic dissection, Aortic surgery, Extra-corporeal life support, Extracorporeal membrane oxygenation, Extracorporeal life support, Mechanical circulatory support

Core tip: The subject of our review remains controversial in the absence of clear evidence but mainly based on opinions and speculations. We believe that such a timely review may contribute to reconsider current thinking and address the subject with an open mind.