Riebandt J, et al. - In this study, authors presented their institutional experience with extracorporeal membrane oxygenation (ECMO)-facilitated right ventricular (RV) support after left ventricular assist device implantation. They achieved good long-term outcomes and high rates of RV recovery with temporary ECMO-facilitated RV support.

Methods

• A retrospective review was performed of the concept of temporary ECMO support for perioperative RV failure in 32 consecutive left ventricular assist device (mean age 52 ± 14 years; male 84.4%; ischaemic cardiomyopathy 40.6%; INTERMACS Level I 71.8%; INTERMACS Level II 6.3%; INTERMACS Level III 12.5%; INTERMACS Level IV–VII 9.4%; HeartWare ventricular assist device 75%; HeartMate II: 25%) from May 2009 to April 2014.
• RV recovery during ECMO support, mortality and causes of death were observed as the study end points.

Results

• Researchers successfully weaned 29 (90.6%) patients from ECMO support after RV recovery.
• During ECMO support, 3 (9.4%) patients died.
• With ECMO support, RV function and haemodynamic parameters improved (central venous pressure 13 mmHg vs 10 mmHg, P < 0.01; mean pulmonary artery pressure 28 mmHg vs 21 mmHg, P < 0.01; cardiac output 5.1 l/min vs 5.9 l/min, P = 0.09) over a median period of 3 (range 1–15) days.
• In this study, thirty-day and in-hospital mortality were 18.8% and 25%, respectively.
• Findings revealed one-year survival of 75%; causes of death included multiorgan dysfunction syndrome (50%), sepsis (25%), haemorrhagic stroke (12.5%) and ischaemic stroke (12.5%).
• During ECMO support, causes of death were ischaemic stroke, sepsis and multiorgan dysfunction syndrome.