%0 Journal Article
%T Prolonged veno
%A Dipanjan Banerjee
%A Sabina PW Guenther
%A William Hiesinger
%A Yasuhiro Shudo
%J The International Journal of Artificial Organs
%@ 1724-6040
%D 2018
%R 10.1177/0391398818777359
%X In intractable cardiogenic shock, extracorporeal life support frequently is the last treatment option. Outcomes of prolonged veno-arterial extracorporeal life support for cardiac failure are poorly defined. We retrospectively analyzed 10 patients (4 females, age£¿=£¿36£¿¡À£¿16£¿years) who underwent prolonged extracorporeal life support (¡Ý7£¿days) from December 2015 to March 2017 for cardiogenic shock. The primary endpoint was survival to hospital discharge. Etiologies included ischemic cardiomyopathy with non ST-segment elevation myocardial infarction (n£¿=£¿1), dilated (n£¿=£¿3), hypertrophic (n£¿=£¿1), postpartum cardiomyopathy (n£¿=£¿1), and others (n£¿=£¿4). Heart failure was left or biventricular in 80.0% (left ventricular ejection fraction£¿=£¿15.6£¿¡À£¿5.5%). Among the 10 patients, 80.0% underwent femoral and 20.0% central cannulation, 40.0% required changes in the cannulation strategy, and 80.0% underwent left ventricular venting. No technical malfunctions occurred, but 50.0% required circuit exchanges for thrombus formation. 80.0% suffered from infections. 60.0% could be decannulated after 717£¿¡À£¿830 (168¨C2301)£¿h of support, and survival to hospital discharge was 40.0%. Longest follow-up available is 160£¿¡À£¿175 (12¨C409)£¿days after discharge, with 30.0% alive and in satisfying functional condition. Prolonged veno-arterial extracorporeal life support for cardiac failure is feasible with low technical complication rates. Survival rates are acceptable, yet inferior to short-term support. We observed a shift from initial shock-related complications to infections during prolonged support. Since recovery and thus weaning is rather unlikely after a prolonged need for extracorporeal life support, this form of support should be limited to centers offering the full spectrum of interdisciplinary cardiac care including ventricular assist device implantation and transplantation
%K Cardiogenic shock
%K extracorporeal life support
%K outcome
%K prolonged duration
%U https://journals.sagepub.com/doi/full/10.1177/0391398818777359