초록접수 현황
| 17F-255 | 포럼 발표 |
Outcome in Patients of Cardiopulmonary Collapse Having Salvage Coronary Artery Bypass Grafting with using Extracorporeal Membrane Oxygenation
Soojin Park, Ji Ye Park, Joonho Jung, You Sun Hong, Cheol Joo Lee, Sang-Hyun Lim
Department of Thoracic and Cardiovascular Surgery, Ajou University Hospital, Ajou University School of Medicine, Gyeonggi-do, Republic of Korea
Purpose : Emergency revascularization has been reported to increase survival in patients with refractory cardiac arrest complicated by acute coronary syndrome (ACS). However there is a controversy about emergent revascularization to all ACS patients. Moreover we investigated the beneficial effect of combining extracorporeal membrane oxygenation (ECMO) and emergency coronary revascularization by coronary artery bypass grafting(CABG) in all patients who have had a acute myocardial infarction (AMI)-induced cardiopulmonary collapse.
Methods : This retrospective study included 21 patients rescued by ECMO for AMI-induced cardiopulmonary collapse in a single institution between March 2007 and July 2017. Coronary revascularization was performed right after ECMO initiation. Percutaneous coronary intervention (PCI) was the primary revascularization strategy. CABG was performed if an unsuitable anatomy or unsatisfactory result of PCI. We analyzed the clinical outcome which was defined as all-cause death of the 21 patients
Results : All the 21 patients underwent ECMO prior to CABG. Among them, 10 patients(47.6%) received bystander-cardiopulmonary resuscitation(CPR) and 7 patients received extracorporeal cardiopulmonary resuscitation (ECPR). The mean predicted mortality of Euro-SCORE II was 65.73±16.46%. Four patients(19.0%) has been dead during 30 days and six patients(28.6%) during in hospital stay. Rate of weaning ECMO is 71.4%(15 patients).Patients who were weaned of ECMO and received shorter periods of ECPR are statistically significant factors of affect to difference outcome. It is very meaningful that shorter time interval from collapse to revascularization predict better clinical outcome in patients with ACS undergoing ECPR
Conclusion : Early revascularization by CABG after ECMO is practical to preserve myocardial viability and bridge patients collapsing with AMI to recovery
Methods : This retrospective study included 21 patients rescued by ECMO for AMI-induced cardiopulmonary collapse in a single institution between March 2007 and July 2017. Coronary revascularization was performed right after ECMO initiation. Percutaneous coronary intervention (PCI) was the primary revascularization strategy. CABG was performed if an unsuitable anatomy or unsatisfactory result of PCI. We analyzed the clinical outcome which was defined as all-cause death of the 21 patients
Results : All the 21 patients underwent ECMO prior to CABG. Among them, 10 patients(47.6%) received bystander-cardiopulmonary resuscitation(CPR) and 7 patients received extracorporeal cardiopulmonary resuscitation (ECPR). The mean predicted mortality of Euro-SCORE II was 65.73±16.46%. Four patients(19.0%) has been dead during 30 days and six patients(28.6%) during in hospital stay. Rate of weaning ECMO is 71.4%(15 patients).Patients who were weaned of ECMO and received shorter periods of ECPR are statistically significant factors of affect to difference outcome. It is very meaningful that shorter time interval from collapse to revascularization predict better clinical outcome in patients with ACS undergoing ECPR
Conclusion : Early revascularization by CABG after ECMO is practical to preserve myocardial viability and bridge patients collapsing with AMI to recovery
책임저자: Sang-Hyun Lim
Department of Thoracic and Cardiovascular Surgery, Ajou University Hospital, Ajou University School of Medicine, Gyeonggi-do, Republic of Korea
발표자: Soojin Park, E-mail : soojinima@gmail.com