Browsing by Author "Pacini D."

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    Extracorporeal Life Support for Post-Cardiotomy Acute Right Ventricular Failure: A Retrospective Observational Multicenter Study
    (2026-01-01) Bianchi G.; Perazzo A.; Mariani S.; van Bussel B.C.T.; Di Mauro M.; Wiedemann D.; Saeed D.; Pozzi M.; Botta L.; Boeken U.; Samalavicius R.; Bounader K.; Hou X.; Bunge J.J.H.; Buscher H.; Salazar L.; Meyns B.; Mazzeffi M.A.; Matteucci S.; Sponga S.; Ramanathan K.; Russo C.F.; Formica F.; Sakiyalak P.; Fiore A.; Camboni D.; Raffa G.M.; Diaz R.; Wang I.w.; Jung J.S.; Belohlavek J.; Pellegrino V.; Pettinari M.; Barbone A.; Gaiotto F.A.; Garcia J.P.; Shekar K.; Whitman G.; Solinas M.; Lorusso R.; Heuts S.; Schaefer A.K.; Conci L.; Khalil J.; Lehmann S.; Obadia J.F.; Loforte A.; Pacini D.; Kalampokas N.; Jankuviene A.; Flecher E.; Reis Miranda D.D.; Sriranjan K.; Herr D.; Di Eusanio M.; Vendramin I.; MacLaren G.; Sorokin V.; Costetti A.; Marchetto G.; Schmid C.; Castillo R.; Grus T.; Bianchi G.; Mahidol University
    Background Post-cardiotomy acute right ventricular failure (aRVF) constitutes a complex clinical challenge that might necessitate escalating interventions, including extracorporeal life support (ECLS). This study evaluated outcomes of adults requiring ECLS for post-cardiotomy aRVF compared with other post-cardiotomy indications. Methods In this multicenter, international, retrospective study, we analyzed patients undergoing post-cardiotomy ECLS from January 2000 to December 2020 and compared patients’ characteristics and in-hospital mortality between aRVF and other indications. Results Of 2010 patients, 240 (12%) had aRVF and 1770 (88%) had other indications for ECLS. Demographics were similar between groups; median age was 65 (55-72) years ( P = .217), and 60% were male ( P = .675). The aRVF group showed higher preoperative right-sided cardiac dysfunction, including preexisting right ventricular failure (aRVF, 22%; other indications, 8%; P < .001) and biventricular failure (aRVF, 12%; other indications, 7%; P = .013). Patients with aRVF more frequently underwent tricuspid valve surgery (aRVF, 20%; other indications, 13%; P = .003) and aortic root procedures (aRVF, 24%; other indications, 13%). They also required longer ECLS support (aRVF, 135 [70-221] hours; other indications, 116 [58-192] hours; P = .025) and longer intensive care unit stay (aRVF, 15 [7-29] days; other indications, 13 [6-25] days; P = .042). Despite more complications, including nonsurgical bleeding (aRVF, 31%; other indications, 25%; P = .042) and persistent right-sided heart failure (aRVF, 50%; other indications, 17%; P < .001), both in-hospital survival (aRVF, 59%; other indications, 61%; P = .526) and long-term survival were comparable (log-rank P = .17). Conclusions Patients requiring ECLS for post-cardiotomy aRVF, despite higher preoperative risks and complex clinical courses, achieve survival rates comparable to those of patients with other indications.