FIVE-YEAR EXPERIENCE IN PERIPHERAL VENOARTERIAL EXTRACORPOREAL MEMBRANE OXYGENATION AS A METHOD OF MECHANICAL CIRCULATORY SUPPORT IN POTENTIAL HEART TRANSPLANT RECIPIENTS
Introduction. Venoarterial extracorporeal membrane oxygenation (VA ECMO) is one of the most widely used methods of temporary mechanical circulatory support (MCS) during the preparation and performance of heart transplant surgery (HT) [Barth E. et al., 2012; Kittleson M.M. et al., 2011].Aim of this s...
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| Format: | Article |
| Language: | Russian |
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Federal Research Center of Transplantology and Artificial Organs named after V.I.Shumakov
2017-01-01
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| Series: | Вестник трансплантологии и искусственных органов |
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| Online Access: | https://journal.transpl.ru/vtio/article/view/697 |
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| author | S. V. Gautier V. N. Poptsov V. M. Zakharevich A. O. Shevchenko E. A. Spirina S. G. Ukhrenkov S. A. Masyutin E. Z. Aliyev V. Yu. Voronkov N. S. Chibisov S. Yu. Ustin D. M. Bondarenko |
| author_facet | S. V. Gautier V. N. Poptsov V. M. Zakharevich A. O. Shevchenko E. A. Spirina S. G. Ukhrenkov S. A. Masyutin E. Z. Aliyev V. Yu. Voronkov N. S. Chibisov S. Yu. Ustin D. M. Bondarenko |
| author_sort | S. V. Gautier |
| collection | DOAJ |
| description | Introduction. Venoarterial extracorporeal membrane oxygenation (VA ECMO) is one of the most widely used methods of temporary mechanical circulatory support (MCS) during the preparation and performance of heart transplant surgery (HT) [Barth E. et al., 2012; Kittleson M.M. et al., 2011].Aim of this study was to assess the effectiveness of using peripheral VA ECMO as a method of mechanical circulatory support in potential heart transplant recipients that urgently required transplantation.Materials and methods. The study included 125 potential heart transplant recipients (107 (86%) men and 18 (14%) women) aged from 12 to 72 (43 ± 1.2) years with a peripheral VA ECMO system installed within the period from April 01, 2011 till August 12, 2016. The indication for the start of its use was rapidly progressing congestive heart failure (CHF) of level 1 or 2 by the INTERMACS scale. Femoral blood vessel cannulation was performed using both open (surgical) and closed (puncture) methods. 23 and 25 F venous cannulae were utilized for femoral vein cannulation, and 15 and 17 F arterial cannulae were utilized for femoral artery cannulation. In all cases superfi cial femoral artery catheterization (14 F single-lumen catheter) or cannulation (8 or 10 F arterial cannula) was performed in the descending (anterograde) direction for the prevention of lower limb ischemia on the side of the femoral artery cannulation.Results. The peripheral cannulation method was used to perform VA ECMO in 100% (n = 125) observations. In 69 (55.2%) patients the severity of progressive CHF corresponded to INTERMACS level 1; in 51 (40.8%) cases it corresponded to INTERMACS level 2. During VA ECMO the average volumetric extracorporeal circulation fl ow rate ranged from 2.2 to 4.5 (3.2 ± 0.4 l/min) or 1.6 ± 0.2 l/min/m2 with the average rotation speed of the centrifugal pump of 3.216 ± 105 rpm. 113 (90.4%) of 125 potential recipients underwent HT. The duration of VA ECMO prior to HT (n = 113) was from 8 hours to 40 (7.1 ± 2.7) days: in 37 (32.7%) of 113 patients – up to 3 days, in 43 (38.1%) cases – from 4 to 7 days, in 21 (18.6%) cases – from 8 to 14 days, in 8 (7.1%) cases from 15 to 21 days, in 4 (3.5%) cases – more than 3 weeks. In the course of VA ECMO, 12 (9.6%) of 125 potential recipients (11 men and 1 women aged from 21 to 63 (40 ± 4) died before they could receive HT. In 2 (16.7%) of 12 cases the cause of death was brain death associated with a thromboembolic cerebrovascular event. The majority of patients (n = 10; 83.3%) died of progressive multiple organ failure and sepsis. 6 of 12 patients showed clinical and instrumental signs of acute unilateral (n = 2) or bilateral (n = 4) polysegmental pneumonia.Conclusion. Peripheral VA ECMO provides a successful bridge to heart transplant procedure in 90% of potential recipients who need pre-transplant MCS. The timely initiation of VA ECMO before the development of pronounced hemodynamic, organ, electrolyte and metabolic disorders creates the conditions for a successful use of MCS in potential heart transplant recipients. |
| first_indexed | 2024-04-10T00:52:46Z |
| format | Article |
| id | doaj.art-389600c9bebd4153833dd144b7ba2544 |
| institution | Directory Open Access Journal |
| issn | 1995-1191 |
| language | Russian |
| last_indexed | 2025-03-14T05:32:19Z |
| publishDate | 2017-01-01 |
| publisher | Federal Research Center of Transplantology and Artificial Organs named after V.I.Shumakov |
| record_format | Article |
| series | Вестник трансплантологии и искусственных органов |
| spelling | doaj.art-389600c9bebd4153833dd144b7ba25442025-03-05T14:11:49ZrusFederal Research Center of Transplantology and Artificial Organs named after V.I.ShumakovВестник трансплантологии и искусственных органов1995-11912017-01-01184162510.15825/1995-1191-2016-4-16-32581FIVE-YEAR EXPERIENCE IN PERIPHERAL VENOARTERIAL EXTRACORPOREAL MEMBRANE OXYGENATION AS A METHOD OF MECHANICAL CIRCULATORY SUPPORT IN POTENTIAL HEART TRANSPLANT RECIPIENTSS. V. Gautier0V. N. Poptsov1V. M. Zakharevich2A. O. Shevchenko3E. A. Spirina4S. G. Ukhrenkov5S. A. Masyutin6E. Z. Aliyev7V. Yu. Voronkov8N. S. Chibisov9S. Yu. Ustin10D. M. Bondarenko11V.I. Shumakov Federal Research Center of Transplantology and Artifi cial Organs of the Ministry of Healthcare of the Russian Federation I.M. Sechenov First Moscow State Medical UniversityV.I. Shumakov Federal Research Center of Transplantology and Artifi cial Organs of the Ministry of Healthcare of the Russian FederationV.I. Shumakov Federal Research Center of Transplantology and Artifi cial Organs of the Ministry of Healthcare of the Russian Federation I.M. Sechenov First Moscow State Medical UniversityV.I. Shumakov Federal Research Center of Transplantology and Artifi cial Organs of the Ministry of Healthcare of the Russian Federation I.M. Sechenov First Moscow State Medical UniversityV.I. Shumakov Federal Research Center of Transplantology and Artifi cial Organs of the Ministry of Healthcare of the Russian FederationV.I. Shumakov Federal Research Center of Transplantology and Artifi cial Organs of the Ministry of Healthcare of the Russian FederationV.I. Shumakov Federal Research Center of Transplantology and Artifi cial Organs of the Ministry of Healthcare of the Russian FederationV.I. Shumakov Federal Research Center of Transplantology and Artifi cial Organs of the Ministry of Healthcare of the Russian FederationV.I. Shumakov Federal Research Center of Transplantology and Artifi cial Organs of the Ministry of Healthcare of the Russian FederationV.I. Shumakov Federal Research Center of Transplantology and Artifi cial Organs of the Ministry of Healthcare of the Russian FederationV.I. Shumakov Federal Research Center of Transplantology and Artifi cial Organs of the Ministry of Healthcare of the Russian FederationV.I. Shumakov Federal Research Center of Transplantology and Artifi cial Organs of the Ministry of Healthcare of the Russian FederationIntroduction. Venoarterial extracorporeal membrane oxygenation (VA ECMO) is one of the most widely used methods of temporary mechanical circulatory support (MCS) during the preparation and performance of heart transplant surgery (HT) [Barth E. et al., 2012; Kittleson M.M. et al., 2011].Aim of this study was to assess the effectiveness of using peripheral VA ECMO as a method of mechanical circulatory support in potential heart transplant recipients that urgently required transplantation.Materials and methods. The study included 125 potential heart transplant recipients (107 (86%) men and 18 (14%) women) aged from 12 to 72 (43 ± 1.2) years with a peripheral VA ECMO system installed within the period from April 01, 2011 till August 12, 2016. The indication for the start of its use was rapidly progressing congestive heart failure (CHF) of level 1 or 2 by the INTERMACS scale. Femoral blood vessel cannulation was performed using both open (surgical) and closed (puncture) methods. 23 and 25 F venous cannulae were utilized for femoral vein cannulation, and 15 and 17 F arterial cannulae were utilized for femoral artery cannulation. In all cases superfi cial femoral artery catheterization (14 F single-lumen catheter) or cannulation (8 or 10 F arterial cannula) was performed in the descending (anterograde) direction for the prevention of lower limb ischemia on the side of the femoral artery cannulation.Results. The peripheral cannulation method was used to perform VA ECMO in 100% (n = 125) observations. In 69 (55.2%) patients the severity of progressive CHF corresponded to INTERMACS level 1; in 51 (40.8%) cases it corresponded to INTERMACS level 2. During VA ECMO the average volumetric extracorporeal circulation fl ow rate ranged from 2.2 to 4.5 (3.2 ± 0.4 l/min) or 1.6 ± 0.2 l/min/m2 with the average rotation speed of the centrifugal pump of 3.216 ± 105 rpm. 113 (90.4%) of 125 potential recipients underwent HT. The duration of VA ECMO prior to HT (n = 113) was from 8 hours to 40 (7.1 ± 2.7) days: in 37 (32.7%) of 113 patients – up to 3 days, in 43 (38.1%) cases – from 4 to 7 days, in 21 (18.6%) cases – from 8 to 14 days, in 8 (7.1%) cases from 15 to 21 days, in 4 (3.5%) cases – more than 3 weeks. In the course of VA ECMO, 12 (9.6%) of 125 potential recipients (11 men and 1 women aged from 21 to 63 (40 ± 4) died before they could receive HT. In 2 (16.7%) of 12 cases the cause of death was brain death associated with a thromboembolic cerebrovascular event. The majority of patients (n = 10; 83.3%) died of progressive multiple organ failure and sepsis. 6 of 12 patients showed clinical and instrumental signs of acute unilateral (n = 2) or bilateral (n = 4) polysegmental pneumonia.Conclusion. Peripheral VA ECMO provides a successful bridge to heart transplant procedure in 90% of potential recipients who need pre-transplant MCS. The timely initiation of VA ECMO before the development of pronounced hemodynamic, organ, electrolyte and metabolic disorders creates the conditions for a successful use of MCS in potential heart transplant recipients.https://journal.transpl.ru/vtio/article/view/697heart transplantmechanical circulatory supportecmo |
| spellingShingle | S. V. Gautier V. N. Poptsov V. M. Zakharevich A. O. Shevchenko E. A. Spirina S. G. Ukhrenkov S. A. Masyutin E. Z. Aliyev V. Yu. Voronkov N. S. Chibisov S. Yu. Ustin D. M. Bondarenko FIVE-YEAR EXPERIENCE IN PERIPHERAL VENOARTERIAL EXTRACORPOREAL MEMBRANE OXYGENATION AS A METHOD OF MECHANICAL CIRCULATORY SUPPORT IN POTENTIAL HEART TRANSPLANT RECIPIENTS Вестник трансплантологии и искусственных органов heart transplant mechanical circulatory support ecmo |
| title | FIVE-YEAR EXPERIENCE IN PERIPHERAL VENOARTERIAL EXTRACORPOREAL MEMBRANE OXYGENATION AS A METHOD OF MECHANICAL CIRCULATORY SUPPORT IN POTENTIAL HEART TRANSPLANT RECIPIENTS |
| title_full | FIVE-YEAR EXPERIENCE IN PERIPHERAL VENOARTERIAL EXTRACORPOREAL MEMBRANE OXYGENATION AS A METHOD OF MECHANICAL CIRCULATORY SUPPORT IN POTENTIAL HEART TRANSPLANT RECIPIENTS |
| title_fullStr | FIVE-YEAR EXPERIENCE IN PERIPHERAL VENOARTERIAL EXTRACORPOREAL MEMBRANE OXYGENATION AS A METHOD OF MECHANICAL CIRCULATORY SUPPORT IN POTENTIAL HEART TRANSPLANT RECIPIENTS |
| title_full_unstemmed | FIVE-YEAR EXPERIENCE IN PERIPHERAL VENOARTERIAL EXTRACORPOREAL MEMBRANE OXYGENATION AS A METHOD OF MECHANICAL CIRCULATORY SUPPORT IN POTENTIAL HEART TRANSPLANT RECIPIENTS |
| title_short | FIVE-YEAR EXPERIENCE IN PERIPHERAL VENOARTERIAL EXTRACORPOREAL MEMBRANE OXYGENATION AS A METHOD OF MECHANICAL CIRCULATORY SUPPORT IN POTENTIAL HEART TRANSPLANT RECIPIENTS |
| title_sort | five year experience in peripheral venoarterial extracorporeal membrane oxygenation as a method of mechanical circulatory support in potential heart transplant recipients |
| topic | heart transplant mechanical circulatory support ecmo |
| url | https://journal.transpl.ru/vtio/article/view/697 |
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