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02.05.2018 | Original Article

Outcomes of patients requiring extracorporeal membrane oxygenation in transcatheter aortic valve implantation: a clinical case series

verfasst von: Ryosuke Higuchi, Tetsuya Tobaru, Kenichi Hagiya, Mike Saji, Itaru Takamisawa, Jun Shimizu, Nobuo Iguchi, Shuichiro Takanashi, Morimasa Takayama, Mitsuaki Isobe

Erschienen in: Heart and Vessels | Ausgabe 11/2018

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Abstract

Transcatheter aortic valve implantation (TAVI) has been established as a low-invasive therapy for aortic stenosis, but circulatory collapse necessitating mechanical circulatory support could occur during TAVI due to procedure itself or procedural complications. The purpose of this study is to describe the outcomes of patients requiring extracorporeal membrane oxygenation (ECMO) in TAVI. Among 384 consecutive patients undergoing TAVI from April 2010 to July 2017 in Sakakibara Heart Institute, we evaluated seven patients (1.8%) who required ECMO during procedure. The definitions of outcome were derived from Valve Academic Research Consortium-2 criteria. The indication of ECMO included bridge to emergent surgery due to mechanical complication (n = 3) [aortic root rupture (n = 2), and left-ventricle rupture (n = 1); emergent use], bridge to recovery from cardiac stunning (n = 3; emergent use), and circulatory support for cardiogenic shock (n = 1; prophylactic use). All patients were cannulated from femoral artery and vein, and there was no ECMO-related complication. Six out of seven patients were weaned from ECMO during the TAVI procedure, whereas the other patient with annulus rupture died the following day after TAVI. Five patients survived to discharge [postoperative hospital stay: 27.6 ± 24.3 (23) days]. During mean follow-up of 253 days, a total of three patients died due to annulus rupture, refractory heart failure, and pneumonia, respectively. ECMO is effective and a safe mechanical support device during TAVI. The mid-term outcomes of patients who needed ECMO were unfavorable. Further evolution of transcatheter heart valve is essential, and prophylactic ECMO may contribute to better prognosis in selected patients.
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Metadaten
Titel
Outcomes of patients requiring extracorporeal membrane oxygenation in transcatheter aortic valve implantation: a clinical case series
verfasst von
Ryosuke Higuchi
Tetsuya Tobaru
Kenichi Hagiya
Mike Saji
Itaru Takamisawa
Jun Shimizu
Nobuo Iguchi
Shuichiro Takanashi
Morimasa Takayama
Mitsuaki Isobe
Publikationsdatum
02.05.2018
Verlag
Springer Japan
Erschienen in
Heart and Vessels / Ausgabe 11/2018
Print ISSN: 0910-8327
Elektronische ISSN: 1615-2573
DOI
https://doi.org/10.1007/s00380-018-1183-8

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