The use of veno-arterial extra corporeal membrane oxygenation for hemodynamics support during high-risk percutaneous coronary intervention
Abstract Background Complex coronary artery disease still a major health problem, whether high-risk PCI on V-A ECMO or not is a better choice. Aim and objectives The study is designed to assess the outcomes of using V-A ECMO on high-risk PCI procedures. Patients and methods A prospective interventio...
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| Language: | English |
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Springer
2025-02-01
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| Series: | Egyptian Journal of Critical Care Medicine |
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| Online Access: | https://doi.org/10.1007/s44349-024-00014-w |
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| author | Wael Samy Helmy Elghawaby Akram Abdelbary Hany Zakaria Mohamed Alia Hassan Abdel Fattah |
| author_facet | Wael Samy Helmy Elghawaby Akram Abdelbary Hany Zakaria Mohamed Alia Hassan Abdel Fattah |
| author_sort | Wael Samy |
| collection | DOAJ |
| description | Abstract Background Complex coronary artery disease still a major health problem, whether high-risk PCI on V-A ECMO or not is a better choice. Aim and objectives The study is designed to assess the outcomes of using V-A ECMO on high-risk PCI procedures. Patients and methods A prospective interventional study performed on patients with viable ischemic myocardium who refused CABG, syntax score>22, excluding scarred myocardium. V-A ECMO (Fem-Fem configuration) will be initiated during elective high-risk PCI procedure, compared to patients who underwent high-risk PCI refusing ECMO, also excluding patients suffering from acute decompensated heart failure. Results This is a case-control study where total of 20 patients were identified, 10 patients underwent high-risk PCI on V-A ECMO support, (Control group) 10 patients underwent high-risk PCI without V-A ECMO; our study showed a statistically significant higher SYNTAX score in group 1 than that in group 2, p value 0.025, no statistically significance difference between the number of cases with left main lesions, unprotected LM and MVD between group 1 and group 2, average ECMO duration of 2.5 h, 6 patients on awake ECMO, and statistically non-significant difference between NYHA class between group 1 and group 2. Also our study showed no statistically difference between LV EF before and after PCI in both groups; in group 1, eight patients had complete revascularization in one session while in group 2 only seven patients had complete revascularization; one patient in group 1 had VT while in group 2, one patient had VF and another one suffered of asystole; group 1 patients all discharged home within 1 week while group 2 had two mortalities during PCI. Conclusion ECMO can be successfully used to facilitate elective high-risk PCI minimizing risk of cardiovascular complications. |
| format | Article |
| id | doaj-art-63b32b5cbb274931bc4da6c24445f68b |
| institution | Kabale University |
| issn | 2090-7303 2090-9209 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Springer |
| record_format | Article |
| series | Egyptian Journal of Critical Care Medicine |
| spelling | doaj-art-63b32b5cbb274931bc4da6c24445f68b2025-02-09T12:26:09ZengSpringerEgyptian Journal of Critical Care Medicine2090-73032090-92092025-02-011211610.1007/s44349-024-00014-wThe use of veno-arterial extra corporeal membrane oxygenation for hemodynamics support during high-risk percutaneous coronary interventionWael Samy0Helmy Elghawaby1Akram Abdelbary2Hany Zakaria Mohamed3Alia Hassan Abdel Fattah4Department of Critical Care Medicine, Faculty of Medicine - Cairo UniversityDepartment of Critical Care Medicine, Faculty of Medicine - Cairo UniversityDepartment of Critical Care Medicine, Faculty of Medicine - Cairo UniversityDepartment of Critical Care Medicine, Faculty of Medicine - Cairo UniversityDepartment of Critical Care Medicine, Faculty of Medicine - Cairo UniversityAbstract Background Complex coronary artery disease still a major health problem, whether high-risk PCI on V-A ECMO or not is a better choice. Aim and objectives The study is designed to assess the outcomes of using V-A ECMO on high-risk PCI procedures. Patients and methods A prospective interventional study performed on patients with viable ischemic myocardium who refused CABG, syntax score>22, excluding scarred myocardium. V-A ECMO (Fem-Fem configuration) will be initiated during elective high-risk PCI procedure, compared to patients who underwent high-risk PCI refusing ECMO, also excluding patients suffering from acute decompensated heart failure. Results This is a case-control study where total of 20 patients were identified, 10 patients underwent high-risk PCI on V-A ECMO support, (Control group) 10 patients underwent high-risk PCI without V-A ECMO; our study showed a statistically significant higher SYNTAX score in group 1 than that in group 2, p value 0.025, no statistically significance difference between the number of cases with left main lesions, unprotected LM and MVD between group 1 and group 2, average ECMO duration of 2.5 h, 6 patients on awake ECMO, and statistically non-significant difference between NYHA class between group 1 and group 2. Also our study showed no statistically difference between LV EF before and after PCI in both groups; in group 1, eight patients had complete revascularization in one session while in group 2 only seven patients had complete revascularization; one patient in group 1 had VT while in group 2, one patient had VF and another one suffered of asystole; group 1 patients all discharged home within 1 week while group 2 had two mortalities during PCI. Conclusion ECMO can be successfully used to facilitate elective high-risk PCI minimizing risk of cardiovascular complications.https://doi.org/10.1007/s44349-024-00014-wMechanical circulatory supportVeno-arterial extra corporeal membraneOxygenationPercutaneous coronary interventionNew York Heart AssociationLeft ventricleEjection fraction |
| spellingShingle | Wael Samy Helmy Elghawaby Akram Abdelbary Hany Zakaria Mohamed Alia Hassan Abdel Fattah The use of veno-arterial extra corporeal membrane oxygenation for hemodynamics support during high-risk percutaneous coronary intervention Egyptian Journal of Critical Care Medicine Mechanical circulatory support Veno-arterial extra corporeal membraneOxygenation Percutaneous coronary intervention New York Heart Association Left ventricle Ejection fraction |
| title | The use of veno-arterial extra corporeal membrane oxygenation for hemodynamics support during high-risk percutaneous coronary intervention |
| title_full | The use of veno-arterial extra corporeal membrane oxygenation for hemodynamics support during high-risk percutaneous coronary intervention |
| title_fullStr | The use of veno-arterial extra corporeal membrane oxygenation for hemodynamics support during high-risk percutaneous coronary intervention |
| title_full_unstemmed | The use of veno-arterial extra corporeal membrane oxygenation for hemodynamics support during high-risk percutaneous coronary intervention |
| title_short | The use of veno-arterial extra corporeal membrane oxygenation for hemodynamics support during high-risk percutaneous coronary intervention |
| title_sort | use of veno arterial extra corporeal membrane oxygenation for hemodynamics support during high risk percutaneous coronary intervention |
| topic | Mechanical circulatory support Veno-arterial extra corporeal membraneOxygenation Percutaneous coronary intervention New York Heart Association Left ventricle Ejection fraction |
| url | https://doi.org/10.1007/s44349-024-00014-w |
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