Outcomes of Coronary Artery Bypass Grafting after Extracorporeal Life Support in Patients with Cardiac Arrest or Cardiogenic Shock
Background: Extracorporeal life support (ECLS) is used as a bridge to revascularization in high-risk patients with ischemic heart disease. We reviewed our experiences of coronary artery bypass grafting (CABG) after ECLS in patients with cardiac arrest or refractory cardiogenic shock. Methods: We r...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Korean Society for Thoracic and Cardiovascular Surgery
2019-04-01
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| Series: | Korean Journal of Thoracic and Cardiovascular Surgery |
| Subjects: |
| Summary: | Background: Extracorporeal life support (ECLS) is used as a bridge to revascularization in high-risk patients
with ischemic heart disease. We reviewed our experiences of coronary artery bypass grafting (CABG) after
ECLS in patients with cardiac arrest or refractory cardiogenic shock. Methods: We retrospectively reviewed
4,616 patients who underwent CABG at our institution between May 2006 and February 2017. We identified
patients who underwent CABG following ECLS for cardiogenic shock or cardiac arrest. Twenty-three patients
(0.5% of all CABG cases) were enrolled in the analysis. Their median age was 65 years (Q1–Q3, 58–77
years). Nine patients (39.1%) were diagnosed with ST-elevation myocardial infarction. Mechanical complications
after acute myocardial infarction, including acute mitral regurgitation, left ventricular rupture, and ventricular
septal defect, occurred in 9 patients (39.1%). Results: The median time from cardiopulmonary resuscitation
to ECLS initiation was 25 minutes (Q1–Q3, 18.5–28.5 minutes). Conventional CABG was performed
in 10 patients (43.5%) who underwent concomitant intracardiac procedures. Postoperative ECLS was required
in 16 patients (69.5%). The rate of successful ECLS weaning was 91.3% (n=21). There were 6 early mortalities
(26.1%). Conclusion: CABG after ECLS was very rare in real-world circumstances. Although the early
mortality rate was high, the risk of mortality may be acceptable under such devastating circumstances. |
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| ISSN: | 2233-601X 2093-6516 |