초록접수 현황
| 17F-217 | 구연 발표 |
Central Type Cannulation Converstion from Peripheral Venoarterial Extracorporeal Membrane Oxygenation
Ji young Park, Yang Hyun Cho, Yong Tak Lee, Wook Sung Kim, Kiick Sung, Dong Seop Jeong, Pyo Won Park
Departments of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
Purpose : V-A ECMO support is an accepted lifesaving approach for cardiogenic shock or chronic heart failure both in and, more recently. However, peripheral femoral VA ECMO continues to be hampered by several major limitations. The aim of this study was to report our experience of conversion from peripheral ECMO to various ECLS modalities.
Methods : In this retrospective study, 29 consecutive patients (median age: 56, range: 26-80) underwent conversion from peripheral ECMO to other ECLS modality between May 2013 and March 2017 were included. Patients younger than 18 years were excluded from this study. Diagnoses were dilated cardiomyopathy(n=21), ischemic cardiomyopathy(n=6), myocarditis(n=1) and post operative cardiac arrest(n=1).
Results : Converted ECLS modalities included Central ECMO(n=15), surgical vent insertion(n=5), ventricular assist device(n=7) and hybrid cannulation with one more central cannulation(n=2). Median duration of conversion from peripheral ECMO was 7days(range:0-75 days). The indications for conversion are bridging to heart transplantation without complications related peripheral ECMO(n = 18),limb ischemia or femoral site infection(n=5), poor ECMO flow (n=2), cardiac tamponade due to trauma at insertion of left ventricular vent catheter(n=2) and requiring the vent insertion due to pulmonary edema(n=2). Overall success rate of weaning from ECMO(n=20) was 68.9%. Among all patients weaning from ECMO, 13 patients underwent heart transplantation(13/20,65.0%), 5patients implanted temporary or durable ventricular assist device(5/20, 25.0%) and 2patients recovered heart function(2/20,10.0%). Overall survival rate to hospital discharge(n=17) was 58.6%.
Conclusion : There were various central type cannulation strategies. The cannulation stragegy should be modified according to the patient’s condition and complications. The overall outcome of these patients was reasonably good.
Methods : In this retrospective study, 29 consecutive patients (median age: 56, range: 26-80) underwent conversion from peripheral ECMO to other ECLS modality between May 2013 and March 2017 were included. Patients younger than 18 years were excluded from this study. Diagnoses were dilated cardiomyopathy(n=21), ischemic cardiomyopathy(n=6), myocarditis(n=1) and post operative cardiac arrest(n=1).
Results : Converted ECLS modalities included Central ECMO(n=15), surgical vent insertion(n=5), ventricular assist device(n=7) and hybrid cannulation with one more central cannulation(n=2). Median duration of conversion from peripheral ECMO was 7days(range:0-75 days). The indications for conversion are bridging to heart transplantation without complications related peripheral ECMO(n = 18),limb ischemia or femoral site infection(n=5), poor ECMO flow (n=2), cardiac tamponade due to trauma at insertion of left ventricular vent catheter(n=2) and requiring the vent insertion due to pulmonary edema(n=2). Overall success rate of weaning from ECMO(n=20) was 68.9%. Among all patients weaning from ECMO, 13 patients underwent heart transplantation(13/20,65.0%), 5patients implanted temporary or durable ventricular assist device(5/20, 25.0%) and 2patients recovered heart function(2/20,10.0%). Overall survival rate to hospital discharge(n=17) was 58.6%.
Conclusion : There were various central type cannulation strategies. The cannulation stragegy should be modified according to the patient’s condition and complications. The overall outcome of these patients was reasonably good.
책임저자: Yang Hyun Cho
Departments of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
발표자: Ji young Park, E-mail : chunhaa@naver.com