Contemporary Use of Veno-Arterial Extracorporeal Membrane Oxygenation for Refractory XXXX in Acute Coronary Syndrome.

@entity1 @entity455 @entity1167 @entity583 @entity1455
BACKGROUND: @entity1455 ( @entity1455 ) in @entity583 ( @entity583 ) is associated with high rates of mortality. Smaller ventricular assist devices, such as the intraaortic balloon pump, provide limited support. Venoarterial extracorporeal membrane oxygenation (VA-ECMO) offers more robust mechanical ventricular support, but is not widely utilized by interventional cardiologists. This study aimed to evaluate the @entity1 characteristics and outcomes of VA-ECMO with @entity1455 in the setting of @entity583 . METHODS AND RESULTS: A retrospective chart review of all VA-ECMO cannulations between 2009 and 2014 was performed, and @entity1 with an indication of @entity1455 in @entity583 were identified. A total of 15 @entity1 underwent VA-ECMO placement for @entity583 with @entity1455 . One-third of these @entity1 presented with out-of-hospital @entity1167 , and 60% had ST-elevation @entity583 . The Intraaortic balloon pump was placed in addition to VA-ECMO in 60% of @entity1 . Median duration of VA-ECMO support was 45 hours. Successful wean off VA-ECMO was obtained in 50% of the @entity1 , and @entity455 occurred in 53% of @entity1 . The survival rate at discharge was 47%, and all survivors were alive at 30 days post discharge. CONCLUSION: VA-ECMO is infrequently used in @entity1 for cardiopulmonary resuscitation in the @entity583 setting. When used judiciously, it has good clinical outcomes in this group of @entity1 . However, use of VA-ECMO should be individualized based on vascular anatomy for best results. Close cooperation among interventional cardiologists, cardiovascular surgeons, cardiologists, cardiac intensivists, and perfusionists is essential for success of this therapy for @entity1455 in @entity583 .
