Predicting mortality after postcardiotomy venoarterial extracorporeal membrane oxygenation

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

Abstract

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.