Central conversion from peripheral extracorporeal life support for patients with refractory congestive heart failure

Satsuki Fukushima, Naoki Tadokoro, Ayumi Koga, Yusuke Shimahara, Shin Yajima, Takashi Kakuta, Kensuke Kuroda, Seiko Nakajima, Takuya Watanabe, Masanobu Yanase, Norihide Fukushima, Junjiro Kobayashi, Tomoyuki Fujita

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)

Abstract

Conversion from peripheral extracorporeal life support (ECLS) to the central one can improve and stabilize hemodynamics in patients with refractory congestive heart failure-related multiorgan failure, whereas indication and selection of the type of the central ECLS have not been fully established. Institutional outcome of the conversion therapy was herein reviewed to verify indication and selection of three types of central ECLS. This study enrolled an institutional consecutive surgical series of 24 patients with refractory congestive heart failure under peripheral ECLS, related to fulminant myocarditis (n = 15), dilated cardiomyopathy (n = 5), or acute myocardial infarction (n = 4). They were converted to central Y-extracorporeal membrane oxygenation (ECMO, n = 6), extracorporeal ventricular assist device (EC-VAD, n = 12), or pump catheter (n = 6), dependent upon the degree of multiorgan failure. Despite the different degree of multiorgan failure prior to the conversion, improvement in end-organ perfusion and reduction in right atrial and pulmonary artery pressure were promptly achieved regardless of the type of the central ECLS. There were five in-hospital mortalities (21%) during the central ECLS, whereas mechanical support was weaned-off in 11 cases (46%) and durable LVAD was subsequently implanted for bridge to transplantation in eight cases (33%). Conversion from the peripheral ECLS to the central ones, such as central Y-ECMO, EC-VAD or pump catheter, promptly established a sufficient support with heart and lung unloading in patients with refractory congestive heart failure.

Original languageEnglish
Pages (from-to)214-224
Number of pages11
JournalJournal of Artificial Organs
Volume23
Issue number3
DOIs
Publication statusPublished - 01-09-2020
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Medicine (miscellaneous)
  • Biomaterials
  • Biomedical Engineering
  • Cardiology and Cardiovascular Medicine

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