Outcomes of Extracorporeal Membrane Oxygenation Support for Complex High-Risk Elective Percutaneous Coronary Interventions: A Single-Center Experience and Review of the Literature

Arslan Shaukat, Katarzyna Hryniewicz-Czeneszew, Benjamin Sun, Karol Mudy, Kelly Wilson, Peter Tajti, Larissa Stanberry, Ross Garberich, Yader Sandoval, M. Nicholas Burke, Ivan Chavez, Mario Gössl, Timothy Henry, Daniel Lips, Michael Mooney, Anil Poulose, Paul Sorajja, Jay Traverse, Yale Wang, Steven BradleyEmmanouil S Brilakis

Research output: Contribution to journalArticle

Abstract

OBJECTIVES: Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is most commonly used in patients with cardiac arrest and cardiogenic shock. There are limited data on the use of VA-ECMO for elective, high-risk percutaneous coronary intervention (PCI). We examined the in-hospital and mid-term clinical outcomes in patients undergoing complex, high-risk PCI with VA-ECMO support. METHODS:. We conducted a retrospective review of ECMO-supported elective high-risk PCIs performed at our institution between May 2012 and May 2017. The electronic medical records and angiograms were individually reviewed. We assessed the in-hospital and mid-term major adverse cardiovascular and cerebrovascular event (MACCE) rates, and reviewed bleeding and vascular complications. RESULTS: Five patients underwent elective high-risk PCI with ECMO support. Mean age was 66.8 ± 8.6 years and all patients were men. The mean ejection fraction was 26.6 ± 18.0%. Most procedures were unprotected left main PCIs. All PCIs were successful; 1 patient required femoral artery surgical repair. The mean hospital stay post procedure was 6.4 ± 2.0 days. ECMO was successfully weaned in all cases, and the duration of ECMO was <24 hours in 4 cases. There was no occurrence of in-hospital and 1-year MACCE. CONCLUSION: ECMO can be successfully used for hemodynamic support during elective high-risk PCI.

Original languageEnglish (US)
Pages (from-to)456-460
Number of pages5
JournalJournal of Invasive Cardiology
Volume30
Issue number12
StatePublished - Dec 1 2018

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Extracorporeal Membrane Oxygenation
Percutaneous Coronary Intervention
Cardiogenic Shock
Electronic Health Records
Femoral Artery
Heart Arrest
Blood Vessels
Length of Stay
Angiography
Hemodynamics
Hemorrhage

Keywords

  • Extracorporeal membrane oxygenation
  • High-risk PCI

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Outcomes of Extracorporeal Membrane Oxygenation Support for Complex High-Risk Elective Percutaneous Coronary Interventions : A Single-Center Experience and Review of the Literature. / Shaukat, Arslan; Hryniewicz-Czeneszew, Katarzyna; Sun, Benjamin; Mudy, Karol; Wilson, Kelly; Tajti, Peter; Stanberry, Larissa; Garberich, Ross; Sandoval, Yader; Burke, M. Nicholas; Chavez, Ivan; Gössl, Mario; Henry, Timothy; Lips, Daniel; Mooney, Michael; Poulose, Anil; Sorajja, Paul; Traverse, Jay; Wang, Yale; Bradley, Steven; Brilakis, Emmanouil S.

In: Journal of Invasive Cardiology, Vol. 30, No. 12, 01.12.2018, p. 456-460.

Research output: Contribution to journalArticle

Shaukat, A, Hryniewicz-Czeneszew, K, Sun, B, Mudy, K, Wilson, K, Tajti, P, Stanberry, L, Garberich, R, Sandoval, Y, Burke, MN, Chavez, I, Gössl, M, Henry, T, Lips, D, Mooney, M, Poulose, A, Sorajja, P, Traverse, J, Wang, Y, Bradley, S & Brilakis, ES 2018, 'Outcomes of Extracorporeal Membrane Oxygenation Support for Complex High-Risk Elective Percutaneous Coronary Interventions: A Single-Center Experience and Review of the Literature', Journal of Invasive Cardiology, vol. 30, no. 12, pp. 456-460.
Shaukat, Arslan ; Hryniewicz-Czeneszew, Katarzyna ; Sun, Benjamin ; Mudy, Karol ; Wilson, Kelly ; Tajti, Peter ; Stanberry, Larissa ; Garberich, Ross ; Sandoval, Yader ; Burke, M. Nicholas ; Chavez, Ivan ; Gössl, Mario ; Henry, Timothy ; Lips, Daniel ; Mooney, Michael ; Poulose, Anil ; Sorajja, Paul ; Traverse, Jay ; Wang, Yale ; Bradley, Steven ; Brilakis, Emmanouil S. / Outcomes of Extracorporeal Membrane Oxygenation Support for Complex High-Risk Elective Percutaneous Coronary Interventions : A Single-Center Experience and Review of the Literature. In: Journal of Invasive Cardiology. 2018 ; Vol. 30, No. 12. pp. 456-460.
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abstract = "OBJECTIVES: Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is most commonly used in patients with cardiac arrest and cardiogenic shock. There are limited data on the use of VA-ECMO for elective, high-risk percutaneous coronary intervention (PCI). We examined the in-hospital and mid-term clinical outcomes in patients undergoing complex, high-risk PCI with VA-ECMO support. METHODS:. We conducted a retrospective review of ECMO-supported elective high-risk PCIs performed at our institution between May 2012 and May 2017. The electronic medical records and angiograms were individually reviewed. We assessed the in-hospital and mid-term major adverse cardiovascular and cerebrovascular event (MACCE) rates, and reviewed bleeding and vascular complications. RESULTS: Five patients underwent elective high-risk PCI with ECMO support. Mean age was 66.8 ± 8.6 years and all patients were men. The mean ejection fraction was 26.6 ± 18.0{\%}. Most procedures were unprotected left main PCIs. All PCIs were successful; 1 patient required femoral artery surgical repair. The mean hospital stay post procedure was 6.4 ± 2.0 days. ECMO was successfully weaned in all cases, and the duration of ECMO was <24 hours in 4 cases. There was no occurrence of in-hospital and 1-year MACCE. CONCLUSION: ECMO can be successfully used for hemodynamic support during elective high-risk PCI.",
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T1 - Outcomes of Extracorporeal Membrane Oxygenation Support for Complex High-Risk Elective Percutaneous Coronary Interventions

T2 - A Single-Center Experience and Review of the Literature

AU - Shaukat, Arslan

AU - Hryniewicz-Czeneszew, Katarzyna

AU - Sun, Benjamin

AU - Mudy, Karol

AU - Wilson, Kelly

AU - Tajti, Peter

AU - Stanberry, Larissa

AU - Garberich, Ross

AU - Sandoval, Yader

AU - Burke, M. Nicholas

AU - Chavez, Ivan

AU - Gössl, Mario

AU - Henry, Timothy

AU - Lips, Daniel

AU - Mooney, Michael

AU - Poulose, Anil

AU - Sorajja, Paul

AU - Traverse, Jay

AU - Wang, Yale

AU - Bradley, Steven

AU - Brilakis, Emmanouil S

PY - 2018/12/1

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N2 - OBJECTIVES: Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is most commonly used in patients with cardiac arrest and cardiogenic shock. There are limited data on the use of VA-ECMO for elective, high-risk percutaneous coronary intervention (PCI). We examined the in-hospital and mid-term clinical outcomes in patients undergoing complex, high-risk PCI with VA-ECMO support. METHODS:. We conducted a retrospective review of ECMO-supported elective high-risk PCIs performed at our institution between May 2012 and May 2017. The electronic medical records and angiograms were individually reviewed. We assessed the in-hospital and mid-term major adverse cardiovascular and cerebrovascular event (MACCE) rates, and reviewed bleeding and vascular complications. RESULTS: Five patients underwent elective high-risk PCI with ECMO support. Mean age was 66.8 ± 8.6 years and all patients were men. The mean ejection fraction was 26.6 ± 18.0%. Most procedures were unprotected left main PCIs. All PCIs were successful; 1 patient required femoral artery surgical repair. The mean hospital stay post procedure was 6.4 ± 2.0 days. ECMO was successfully weaned in all cases, and the duration of ECMO was <24 hours in 4 cases. There was no occurrence of in-hospital and 1-year MACCE. CONCLUSION: ECMO can be successfully used for hemodynamic support during elective high-risk PCI.

AB - OBJECTIVES: Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is most commonly used in patients with cardiac arrest and cardiogenic shock. There are limited data on the use of VA-ECMO for elective, high-risk percutaneous coronary intervention (PCI). We examined the in-hospital and mid-term clinical outcomes in patients undergoing complex, high-risk PCI with VA-ECMO support. METHODS:. We conducted a retrospective review of ECMO-supported elective high-risk PCIs performed at our institution between May 2012 and May 2017. The electronic medical records and angiograms were individually reviewed. We assessed the in-hospital and mid-term major adverse cardiovascular and cerebrovascular event (MACCE) rates, and reviewed bleeding and vascular complications. RESULTS: Five patients underwent elective high-risk PCI with ECMO support. Mean age was 66.8 ± 8.6 years and all patients were men. The mean ejection fraction was 26.6 ± 18.0%. Most procedures were unprotected left main PCIs. All PCIs were successful; 1 patient required femoral artery surgical repair. The mean hospital stay post procedure was 6.4 ± 2.0 days. ECMO was successfully weaned in all cases, and the duration of ECMO was <24 hours in 4 cases. There was no occurrence of in-hospital and 1-year MACCE. CONCLUSION: ECMO can be successfully used for hemodynamic support during elective high-risk PCI.

KW - Extracorporeal membrane oxygenation

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