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- Title
Venoarterial extracorporeal membrane oxygenation with or without simultaneous intra-aortic balloon pump support as a direct bridge to heart transplantation: results from a nationwide Spanish registry.
- Authors
Barge-Caballero, Gonzalo; Castel-Lavilla, María A; Almenar-Bonet, Luis; Garrido-Bravo, Iris P; Delgado, Juan F; Rangel-Sousa, Diego; González-Costello, José; Segovia-Cubero, Javier; Farrero-Torres, Marta; Lambert-Rodríguez, José Luis; Crespo-Leiro, María G; Hervás-Sotomayor, Daniela; Portolés-Ocampo, Ana; Martínez-Sellés, Manuel; Fuente-Galán, Luis De la; Rábago-Juan-Aracil, Gregorio; González-Vílchez, Francisco; Mirabet-Pérez, Sonia; Muñiz, Javier; Barge-Caballero, Eduardo
- Abstract
Open in new tab Download slide Open in new tab Download slide OBJECTIVES To investigate the potential clinical benefit of an intra-aortic balloon pump (IABP) in patients supported with venoarterial extracorporeal membrane oxygenation (VA-ECMO) as a bridge to heart transplantation (HT). METHODS We studied 169 patients who were listed for urgent HT under VA-ECMO support at 16 Spanish institutions from 2010 to 2015. The clinical outcomes of patients under simultaneous IABP support (n = 73) were compared to a control group of patients without IABP support (n = 96). RESULTS There were no statistically significant differences between the IABP and control groups with regard to the cumulative rates of transplantation (71.2% vs 81.2%, P = 0.17), death during VA-ECMO support (20.6% vs 14.6%, P = 0.31), transition to a different mechanical circulatory support device (5.5% vs 5.2%, P = 0.94) or weaning from VA-ECMO support due to recovery (2.7% vs 0%, P = 0.10). There was a higher incidence of bleeding events in the IABP group (45.2% vs 25%, P = 0.006; adjusted odds ratio 2.18, 95% confidence interval 1.02–4.67). In-hospital postoperative mortality after HT was 34.6% in the IABP group and 32.5% in the control group (P = 0.80). One-year survival after listing for urgent HT was 53.3% in the IABP group and 52.2% in the control group (log rank P = 0.75). Multivariate adjustment for potential confounders did not change this result (adjusted hazard ratio 0.94, 95% confidence interval 0.56–1.58). CONCLUSIONS In our study, simultaneous IABP therapy in transplant candidates under VA-ECMO support did not significantly reduce morbidity or mortality.
- Publication
Interactive Cardiovascular & Thoracic Surgery, 2019, Vol 29, Issue 5, p670
- ISSN
1569-9293
- Publication type
Article
- DOI
10.1093/icvts/ivz155