Experience of ECMO in Primary Graft Dysfunction after Orthotopic Heart Transplantation
Background:Primary graft dysfunction is the main cause of early mortality after heart transplantation. Mechanical circulatory support has been used to treat this syndrome.Objective:Describe the experience with extracorporeal membrane oxygenation to treat post-transplant primary cardiac graft dysfunction.Methods:Between January 2007 and December 2013, a total of 71 orthotopic heart transplantations were performed in patients with advanced heart failure. Eleven (15.5%) of these patients who presented primary graft dysfunction constituted the population of this study. Primary graft dysfunction manifested in our population as failure to wean from cardiopulmonary bypass in six (54.5%) patients, severe hemodynamic instability in the immediate postoperative period with severe cardiac dysfunction in three (27.3%), and cardiac arrest (18.2%). The average ischemia time was 151 ± 82 minutes. Once the diagnosis of primary graft dysfunction was established, we installed a mechanical circulatory support to stabilize the severe hemodynamic condition of the patients and followed their progression longitudinally.Results:The average duration of extracorporeal membrane oxygenation support was 76 ± 47.4 hours (range 32 to 144 hours). Weaning with cardiac recovery was successful in nine (81.8%) patients. However, two patients who presented cardiac recovery did not survive to hospital discharge.Conclusion:Mechanical circulatory support with central extracorporeal membrane oxygenation promoted cardiac recovery within a few days in most patients.
Main Authors: | , , , , , , , , |
---|---|
Format: | Digital revista |
Language: | English |
Published: |
Sociedade Brasileira de Cardiologia - SBC
2015
|
Online Access: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2015002200285 |
Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
id |
oai:scielo:S0066-782X2015002200285 |
---|---|
record_format |
ojs |
spelling |
oai:scielo:S0066-782X20150022002852015-10-05Experience of ECMO in Primary Graft Dysfunction after Orthotopic Heart TransplantationLima,Elson BorgesCunha,Claudio Ribeiro daBarzilai,Vitor SalvatoreUlhoa,Marcelo BotelhoBarros,Maria Regina deMoraes,Camila ScatolinFortaleza,Letycia ChagasVieira,Nubia WellersonAtik,Fernando Antibas Extracorporeal Membrane Oxygenation / methods Heart Transplantation Primary Graft Dysfunction / physiopathology Postoperative Care Background:Primary graft dysfunction is the main cause of early mortality after heart transplantation. Mechanical circulatory support has been used to treat this syndrome.Objective:Describe the experience with extracorporeal membrane oxygenation to treat post-transplant primary cardiac graft dysfunction.Methods:Between January 2007 and December 2013, a total of 71 orthotopic heart transplantations were performed in patients with advanced heart failure. Eleven (15.5%) of these patients who presented primary graft dysfunction constituted the population of this study. Primary graft dysfunction manifested in our population as failure to wean from cardiopulmonary bypass in six (54.5%) patients, severe hemodynamic instability in the immediate postoperative period with severe cardiac dysfunction in three (27.3%), and cardiac arrest (18.2%). The average ischemia time was 151 ± 82 minutes. Once the diagnosis of primary graft dysfunction was established, we installed a mechanical circulatory support to stabilize the severe hemodynamic condition of the patients and followed their progression longitudinally.Results:The average duration of extracorporeal membrane oxygenation support was 76 ± 47.4 hours (range 32 to 144 hours). Weaning with cardiac recovery was successful in nine (81.8%) patients. However, two patients who presented cardiac recovery did not survive to hospital discharge.Conclusion:Mechanical circulatory support with central extracorporeal membrane oxygenation promoted cardiac recovery within a few days in most patients.info:eu-repo/semantics/openAccessSociedade Brasileira de Cardiologia - SBCArquivos Brasileiros de Cardiologia v.105 n.3 20152015-09-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2015002200285en10.5935/abc.20150082 |
institution |
SCIELO |
collection |
OJS |
country |
Brasil |
countrycode |
BR |
component |
Revista |
access |
En linea |
databasecode |
rev-scielo-br |
tag |
revista |
region |
America del Sur |
libraryname |
SciELO |
language |
English |
format |
Digital |
author |
Lima,Elson Borges Cunha,Claudio Ribeiro da Barzilai,Vitor Salvatore Ulhoa,Marcelo Botelho Barros,Maria Regina de Moraes,Camila Scatolin Fortaleza,Letycia Chagas Vieira,Nubia Wellerson Atik,Fernando Antibas |
spellingShingle |
Lima,Elson Borges Cunha,Claudio Ribeiro da Barzilai,Vitor Salvatore Ulhoa,Marcelo Botelho Barros,Maria Regina de Moraes,Camila Scatolin Fortaleza,Letycia Chagas Vieira,Nubia Wellerson Atik,Fernando Antibas Experience of ECMO in Primary Graft Dysfunction after Orthotopic Heart Transplantation |
author_facet |
Lima,Elson Borges Cunha,Claudio Ribeiro da Barzilai,Vitor Salvatore Ulhoa,Marcelo Botelho Barros,Maria Regina de Moraes,Camila Scatolin Fortaleza,Letycia Chagas Vieira,Nubia Wellerson Atik,Fernando Antibas |
author_sort |
Lima,Elson Borges |
title |
Experience of ECMO in Primary Graft Dysfunction after Orthotopic Heart Transplantation |
title_short |
Experience of ECMO in Primary Graft Dysfunction after Orthotopic Heart Transplantation |
title_full |
Experience of ECMO in Primary Graft Dysfunction after Orthotopic Heart Transplantation |
title_fullStr |
Experience of ECMO in Primary Graft Dysfunction after Orthotopic Heart Transplantation |
title_full_unstemmed |
Experience of ECMO in Primary Graft Dysfunction after Orthotopic Heart Transplantation |
title_sort |
experience of ecmo in primary graft dysfunction after orthotopic heart transplantation |
description |
Background:Primary graft dysfunction is the main cause of early mortality after heart transplantation. Mechanical circulatory support has been used to treat this syndrome.Objective:Describe the experience with extracorporeal membrane oxygenation to treat post-transplant primary cardiac graft dysfunction.Methods:Between January 2007 and December 2013, a total of 71 orthotopic heart transplantations were performed in patients with advanced heart failure. Eleven (15.5%) of these patients who presented primary graft dysfunction constituted the population of this study. Primary graft dysfunction manifested in our population as failure to wean from cardiopulmonary bypass in six (54.5%) patients, severe hemodynamic instability in the immediate postoperative period with severe cardiac dysfunction in three (27.3%), and cardiac arrest (18.2%). The average ischemia time was 151 ± 82 minutes. Once the diagnosis of primary graft dysfunction was established, we installed a mechanical circulatory support to stabilize the severe hemodynamic condition of the patients and followed their progression longitudinally.Results:The average duration of extracorporeal membrane oxygenation support was 76 ± 47.4 hours (range 32 to 144 hours). Weaning with cardiac recovery was successful in nine (81.8%) patients. However, two patients who presented cardiac recovery did not survive to hospital discharge.Conclusion:Mechanical circulatory support with central extracorporeal membrane oxygenation promoted cardiac recovery within a few days in most patients. |
publisher |
Sociedade Brasileira de Cardiologia - SBC |
publishDate |
2015 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2015002200285 |
work_keys_str_mv |
AT limaelsonborges experienceofecmoinprimarygraftdysfunctionafterorthotopichearttransplantation AT cunhaclaudioribeiroda experienceofecmoinprimarygraftdysfunctionafterorthotopichearttransplantation AT barzilaivitorsalvatore experienceofecmoinprimarygraftdysfunctionafterorthotopichearttransplantation AT ulhoamarcelobotelho experienceofecmoinprimarygraftdysfunctionafterorthotopichearttransplantation AT barrosmariareginade experienceofecmoinprimarygraftdysfunctionafterorthotopichearttransplantation AT moraescamilascatolin experienceofecmoinprimarygraftdysfunctionafterorthotopichearttransplantation AT fortalezaletyciachagas experienceofecmoinprimarygraftdysfunctionafterorthotopichearttransplantation AT vieiranubiawellerson experienceofecmoinprimarygraftdysfunctionafterorthotopichearttransplantation AT atikfernandoantibas experienceofecmoinprimarygraftdysfunctionafterorthotopichearttransplantation |
_version_ |
1756381981008986112 |