Background: Gender is known to influence the pathophysiology and pathogenesis of the coronary vascular disease. Data on gender-related differences in patients with veno-arterial extracorporeal membrane oxygenation due to postcardiotomy cardiogenic shock is lacking in current literature. We aimed to analyze the impact of gender on intraoperative and short-term outcomes of vaECMO patients after coronary surgery and postcardiotomy cardiogenic shock.
Methods: Between 2006 and 2017, a total of 92 patients with PCS after CABG underwent vaECMO-implantation at our institution. After a 1:1 propensity score match (PSM) for relevant preoperative data, we identified a cohort of 32 patients, 16 males, and 16 females. Periprocedural and short-term outcome data were analyzed with respect to sex differences.
Results: The mean age was 64 ± 11 years, and 79% ( = 73) were male patients. Clinical outcomes showed a 30-day all-cause mortality of 64% ( = 59). After PSM, male patients showed a significantly smaller number of arterial grafts (0.4 ± 0.53 male vs 1.1 ± 0.7 female; p = 0.037). Thirty-day all-cause mortality did not differ between the groups (56% male vs 75% female; p = 0.262). In general, short-term outcome data were comparable without significant differences for the matched groups.
Conclusion: Gender has no impact on patients with vaECMO therapy due to PCS in isolated coronary surgery.
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http://dx.doi.org/10.1177/02676591211004363 | DOI Listing |
Front Cardiovasc Med
December 2024
Department of Cardiac Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.
Background: Acute type A aortic dissection (ATAAD) poses significant challenges in cardiovascular management due to its high morbidity and mortality rates. Postcardiotomy cardiogenic shock (PCS) is a severe complication following ATAAD repair that complicates postoperative recovery. Extracorporeal membrane oxygenation (ECMO) has emerged as a potential life-saving intervention in this context, yet the specific outcomes related to ECMO in ATAAD patients remain insufficiently studied.
View Article and Find Full Text PDFJ Clin Med
November 2024
Department of Thoracic and Cardiovascular Surgery, West German Heart and Vascular Center, Hufelandstrasse 55, 45147 Essen, Germany.
: Coronary artery bypass surgery (CABG) with multiple arterial grafting (MAG) has shown potential to improve patient survival compared to single arterial bypass grafting. Whether this superiority in survival also exists in diabetics is uncertain. We therefore aimed to compare short and long-term outcomes of MAG in diabetic versus non-diabetic patients.
View Article and Find Full Text PDFInterdiscip Cardiovasc Thorac Surg
December 2024
Department of Cardiovascular Surgery, Kanazawa University, Kanazawa, Japan.
Patients with low-flow, low-gradient severe aortic stenosis and ischaemic cardiomyopathy are at risk for postcardiotomy cardiogenic shock and have a poor prognosis. Although Impella has emerged as a bridge therapy, traditional approaches for Impella insertion are infeasible in patients with peripheral vascular diseases. We successfully managed postcardiotomy cardiogenic shock in a patient with low-flow, low-gradient severe aortic stenosis and ischaemic cardiomyopathy and limited vascular access by introducing Impella via the brachiocephalic artery.
View Article and Find Full Text PDFExpert Rev Med Devices
December 2024
Department of Cardiothoracic and Vascular Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
Introduction: The Impella 5.5 device is a surgically inserted, trans-valvular, microaxial flow device capable of providing 5.5 L/min of continuous, antegrade flow from the left ventricle (LV) to the aorta.
View Article and Find Full Text PDFJ Clin Med
November 2024
Heart and Vascular Institute, Pennsylvania State Milton S Hershey Medical Center, Hershey, PA 17033, USA.
: Patients in cardiogenic shock (CS) may be successfully bridged using intravascular micro-axial left ventricular assist devices (M-LVADs) for recovery or determination of definitive therapy. : One hundred and seven CS patients implanted with M-LVADs from January 2020 to May 2024 were divided into four groups; group-1: 34 patients (transplant); group-2: 25 patients (LVAD); group-3: 42 patients (postcardiotomy CS (PCCS)); group-4: 6 patients (decision/recovery but excluded from analysis). Multivariable logistic regression and Multivariable Coxregression models identified predictors of early -hospital and late mortality, and Odds ratios (ORs) and hazard ratios (HRs) with < 0.
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