Postcardiotomy extracorporeal membrane oxygenation after elective, urgent, and emergency cardiac operations: Insights from the PELS observational study
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item.page.dc.date.issued
2025-01-01
item.page.dc.type
item.page.dc.identifier.eissn
26662736
item.page.dc.identifier.doi
item.page.dc.identifier.scopus
2-s2.0-105000029279
item.page.oaire.citation.title
JTCVS Open
item.page.dc.rights.holder
SCOPUS
item.page.dc.identifier.citation
JTCVS Open (2025)
punsarn.item.page.citation
Mariani S., Perazzo A., De Piero M.E., van Bussel B.C.T., Di Mauro M., Wiedemann D., Lehmann S., Pozzi M., Loforte A., Boeken U., Samalavicius R., Bounader K., Hou X., Bunge J.J.H., Sriranjan K., Salazar L., Meyns B., Mazzeffi M.A., Matteucci S., Sponga S., MacLaren G., Russo C., Formica F., Sakiyalak P., Fiore A., Camboni D., Raffa G.M., Diaz R., Wang I.w., Jung J.S., Belohlavek J., Pellegrino V., Bianchi G., Pettinari M., Barbone A., Garcia J.P., Shekar K., Whitman G., Lorusso R. Postcardiotomy extracorporeal membrane oxygenation after elective, urgent, and emergency cardiac operations: Insights from the PELS observational study. JTCVS Open (2025). doi:10.1016/j.xjon.2025.01.018 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/106823
item.page.dc.title
Postcardiotomy extracorporeal membrane oxygenation after elective, urgent, and emergency cardiac operations: Insights from the PELS observational study
item.page.dc.contributor.author
Mariani S.
Perazzo A.
De Piero M.E.
van Bussel B.C.T.
Di Mauro M.
Wiedemann D.
Lehmann S.
Pozzi M.
Loforte A.
Boeken U.
Samalavicius R.
Bounader K.
Hou X.
Bunge J.J.H.
Sriranjan K.
Salazar L.
Meyns B.
Mazzeffi M.A.
Matteucci S.
Sponga S.
MacLaren G.
Russo C.
Formica F.
Sakiyalak P.
Fiore A.
Camboni D.
Raffa G.M.
Diaz R.
Wang I.w.
Jung J.S.
Belohlavek J.
Pellegrino V.
Bianchi G.
Pettinari M.
Barbone A.
Garcia J.P.
Shekar K.
Whitman G.
Lorusso R.
Perazzo A.
De Piero M.E.
van Bussel B.C.T.
Di Mauro M.
Wiedemann D.
Lehmann S.
Pozzi M.
Loforte A.
Boeken U.
Samalavicius R.
Bounader K.
Hou X.
Bunge J.J.H.
Sriranjan K.
Salazar L.
Meyns B.
Mazzeffi M.A.
Matteucci S.
Sponga S.
MacLaren G.
Russo C.
Formica F.
Sakiyalak P.
Fiore A.
Camboni D.
Raffa G.M.
Diaz R.
Wang I.w.
Jung J.S.
Belohlavek J.
Pellegrino V.
Bianchi G.
Pettinari M.
Barbone A.
Garcia J.P.
Shekar K.
Whitman G.
Lorusso R.
item.page.oairecerif.author.affiliation
Korea University Anam Hospital
Siriraj Hospital
Departement Cardiovasculaire Wetenschappen
National University Health System
Heinrich-Heine-Universität Düsseldorf Medizinische Fakultät
Azienda Ospedaliera Universitaria Ospedali Riuniti, Ancona
Fundación Cardiovascular de Colombia
Beijing Anzhen Hospital, Capital Medical University
CARIM School for Cardiovascular Disease
Ziekenhuis Oost-Limburg
Vilniaus Universitetas
Erasmus MC
UNSW Sydney
Hôpital Pontchaillou
Humanitas Research Hospital
IRCCS Azienda Ospedaliero-Universitaria di Bologna
Hôpital Henri Mondor
Herzzentrum Leipzig
Klinikum der Universität Regensburg und Medizinische Fakultät
Clínica Las Condes
Università degli Studi di Palermo
Charles University
Asst Grande Ospedale Metropolitano Niguarda
Policlinico Universitario, Udine
University of Maryland, Baltimore (UMB)
Fondazione IRCCS San Gerardo dei Tintori
Università degli Studi di Torino
Medizinische Universität Wien
Universidade de São Paulo
The Alfred
Azienda Ospedaliero-Universitaria di Parma
Memorial Healthcare System
The Prince Charles Hospital
The Johns Hopkins Hospital
Methodist Hospital Indianapolis
Ospedale del Cuore Fondazione Toscana “G. Monasterio”
Louis Pradel Cardiologic Hospital
Siriraj Hospital
Departement Cardiovasculaire Wetenschappen
National University Health System
Heinrich-Heine-Universität Düsseldorf Medizinische Fakultät
Azienda Ospedaliera Universitaria Ospedali Riuniti, Ancona
Fundación Cardiovascular de Colombia
Beijing Anzhen Hospital, Capital Medical University
CARIM School for Cardiovascular Disease
Ziekenhuis Oost-Limburg
Vilniaus Universitetas
Erasmus MC
UNSW Sydney
Hôpital Pontchaillou
Humanitas Research Hospital
IRCCS Azienda Ospedaliero-Universitaria di Bologna
Hôpital Henri Mondor
Herzzentrum Leipzig
Klinikum der Universität Regensburg und Medizinische Fakultät
Clínica Las Condes
Università degli Studi di Palermo
Charles University
Asst Grande Ospedale Metropolitano Niguarda
Policlinico Universitario, Udine
University of Maryland, Baltimore (UMB)
Fondazione IRCCS San Gerardo dei Tintori
Università degli Studi di Torino
Medizinische Universität Wien
Universidade de São Paulo
The Alfred
Azienda Ospedaliero-Universitaria di Parma
Memorial Healthcare System
The Prince Charles Hospital
The Johns Hopkins Hospital
Methodist Hospital Indianapolis
Ospedale del Cuore Fondazione Toscana “G. Monasterio”
Louis Pradel Cardiologic Hospital
item.page.dc.contributor.correspondence
item.page.dc.contributor.other
item.page.dc.description.abstract
Background: Outcomes in cardiac surgery are influenced by surgical priority, with higher mortality in emergency cases. Whether this applies to postcardiotomy venoarterial (VA) extracorporeal membrane oxygenation (ECMO) remains unknown. This study describes characteristics and outcomes of patients undergoing cardiac operations and requiring VA ECMO, stratified by emergency, urgent, or elective operation. Methods: This retrospective multicenter observational study included adults requiring postcardiotomy VA ECMO between 2000 and 2020. Preoperative and procedural characteristics, complications, and survival were compared among the 3 patient groups. The association between emergency surgery and in-hospital survival was investigated through mixed Cox proportional hazard models. Results: The study cohort comprised 1063 patients (52.2%) with elective operations, 445 (21.8%) with urgent operations, and 528 (26%) with emergency operations. Emergency operations included more coronary artery bypass grafting operations (n = 286; 54.2%; P <.001) and aortic procedures (n = 126; 23.9%; P =.001) in patients with more unstable preoperative hemodynamic conditions compared to elective and urgent patients. VA ECMO was initiated more frequently intraoperatively in emergency patients (n = 353; 66.9%; P <.001). Postoperative bleeding (n = 338; 64.3%; P <.001), stroke (n = 79; 15%; P <.001), and right ventricular failure (n = 124; 25.3%) were more frequent after emergency operations. In-hospital mortality was 60.5% in the elective group, 57.8% in the urgent group, 63.4% in the emergency group (P =.191). The crude hazard ratio for in-hospital mortality in emergency surgery was 1.15 (95% confidence interval [CI], 1.01-1.32; P =.039) and dropped to 1.09 (95% CI, 0.93-1.27; P =.295) after adjustment for indicators of preoperative instability. 5-year survival was comparable in 30-day survivors (P =.083). Conclusions: One-quarter of postcardiotomy VA ECMOs are implemented after emergency operations. Despite more complications in emergency cases, in-hospital and 5-year survival are comparable between emergency, urgent, or elective operations.