Huang YX, Xu ZM, Zhao L, Cao Y, Chen Y, Qiu YG, Liu YM, Zhang PY, He JC, Li TC. Long-term outcomes of high-risk percutaneous coronary interventions under extracorporeal membrane oxygenation support: An observational study. World J Clin Cases 2022; 10(16): 5266-5274 [PMID: 35812664 DOI: 10.12998/wjcc.v10.i16.5266]
Corresponding Author of This Article
Tian-Chang Li, MD, PhD, Chief Physician, Department of Cardiology, Sixth Medical Center of Chinese People’s Liberation Army General Hospital, No. 6 Fucheng Road, Beijing 100048, China. itc909@163.com
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jun 6, 2022; 10(16): 5266-5274 Published online Jun 6, 2022. doi: 10.12998/wjcc.v10.i16.5266
Long-term outcomes of high-risk percutaneous coronary interventions under extracorporeal membrane oxygenation support: An observational study
Yi-Xiong Huang, Zheng-Ming Xu, Li Zhao, Yi Cao, Yu Chen, Yi-Gang Qiu, Ying-Ming Liu, Peng-Yu Zhang, Jiang-Chun He, Tian-Chang Li
Yi-Xiong Huang, Medical School of Chinese People’s Liberation Army, Beijing 100853, China
Yi-Xiong Huang, Zheng-Ming Xu, Li Zhao, Yi Cao, Yu Chen, Yi-Gang Qiu, Ying-Ming Liu, Peng-Yu Zhang, Jiang-Chun He, Tian-Chang Li, Department of Cardiology, Sixth Medical Center of Chinese People’s Liberation Army General Hospital, Beijing 100048, China
Author contributions: Huang YX, Chen Y, and Li TC designed the study; Huang YX drafted the manuscript; Cao Y, Qiu YG, Liu YM, and He JC revised it critically for important intellectual content; Xu ZM, Zhao L, and Zhang PY contributed to the analysis and interpretation of data; Li TC, the corresponding author of this manuscript, gave final approval of the manuscript submitted.
Institutional review board statement: The study was reviewed and approved by the Sixth Medical Center of PLA General Hospital Institutional Review Board (Beijing).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: Technical appendix, statistical code, and dataset are available from the corresponding author at itc909@163.com.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Tian-Chang Li, MD, PhD, Chief Physician, Department of Cardiology, Sixth Medical Center of Chinese People’s Liberation Army General Hospital, No. 6 Fucheng Road, Beijing 100048, China. itc909@163.com
Received: August 2, 2021 Peer-review started: August 2, 2021 First decision: December 17, 2021 Revised: December 30, 2021 Accepted: April 2, 2022 Article in press: April 2, 2022 Published online: June 6, 2022 Processing time: 303 Days and 20 Hours
Abstract
BACKGROUND
Venoarterial extracorporeal membrane oxygenation (VA-ECMO) offers hemodynamic support for patients undergoing high-risk percutaneous coronary interventions (PCIs). However, long-term outcomes associated with VA-ECMO have not previously been studied.
AIM
To explore long-term outcomes in high-risk cases undergoing PCI supported by VA-ECMO.
METHODS
In the present observational cohort study, 61 patients who received VA-ECMO-supported high-risk PCI between April 2012 and January 2020 at the Sixth Medical Center of Chinese People’s Liberation Army General Hospital were enrolled. The endpoint characteristics such as all-cause mortality, repeated cardiovascular diseases, and cardiac death were examined.
RESULTS
Among 61 patients, three failed stent implantation due to chronic total occlusions with severely calcified lesions. One patient showed VA-ECMO intolerance because of high left ventricular afterload. PCI was successfully performed in 57 patients (93.4%). The in-hospital mortality was 23.0%, and the overall survival was 45.9%, with a median follow-up period of 38.6 (8.6-62.1) mo.
CONCLUSION
VA-ECMO can be used as a support in patients undergoing high-risk PCI as it is associated with favorable long-term patient survival.
Core Tip: High-risk percutaneous coronary intervention (PCI) can result in hemodynamic instability during the perioperative period and is associated with poor outcomes. Venoarterial extracorporeal membrane oxygenation (VA-ECMO) can provide hemodynamic support for patients who undergo high-risk PCI. The main role of VA-ECMO in high-risk PCI is to prevent profound hypotension or low cardiac output episodes and allow sufficient time to achieve optimal and complete revascularization. We present a single-center, observational cohort study of all patients undergoing high-risk PCI supported by VA-ECMO. PCI was successfully performed in 57 patients (93.4%). The in-hospital mortality was 23.0%. The overall survival was 45.9% with a median follow-up time of 38.6 (8.6-62.1) mo. VA-ECMO can be successfully used in patients undergoing high-risk PCI with good long-term survival.
