Predicting mortality after postcardiotomy venoarterial extracorporeal membrane oxygenation

Fausto Biancari, Angelo M. Dell’Aquila, Giovanni Mariscalco


Cardiogenic shock occurring after adult cardiac surgery is often refractory to inotropic therapy and intra-aortic balloon pump mechanical support. In this scenario, venoarterial extracorporeal membrane oxygenation (VA-ECMO) provides both circulatory and respiratory support, allowing cardiopulmonary recovery (1). In extreme circumstances, VA-ECMO support may represent a bridge to implantation of ventricular assist device or to heart transplantation (2). Organizational complexity, excessive costs, even if within the range of cost-effectiveness (3,4), and high early mortality (5) are major limitations of postcardiotomy VA-ECMO.