Intermediate-term results of extracorporeal membrane oxygenation support following congenital heart surgery

S M Peer, D A Emerson, J P Costello, M K Shu, D Zurakowski, R A Jonas, J T Berger, D S Nath

Research output: Chapter in Book/Report/Conference proceedingChapter

3 Scopus citations

Abstract

BACKGROUND: Although there are considerable data regarding in-hospital results of congenital heart surgery (CHS) patients requiring postoperative extracorporeal membrane oxygenation (ECMO) support, there is limited information on intermediate-term outcomes. METHODS: A single-institution retrospective review of 25 consecutive postoperative CHS patients who required ECMO and survived to hospital discharge between January 2003 and June 2008. Survival was estimated by the Kaplan-Meier method. RESULTS: At a median follow-up of 3.3 years (interquartile range: 1.2-5.9 years), there was one death which occurred at six months postsurgery. Kaplan-Meier-estimated survival at three years was 95% (95% confidence interval: 90%-100%). Indications for ECMO included extracorporeal cardiopulmonary resuscitation (48%), systemic hypoxia (4%), postoperative low-cardiac output syndrome (28%), and intraoperative failure to wean off cardiopulmonary bypass (20%). Following ECMO support, 65% of patients had unplanned cardiac reinterventions (three requiring operative interventions, six requiring percutaneous interventions, and four requiring both), and 47% of patients required unplanned hospitalizations. In all, 29% of patients developed neurological deficits and 12% of patients developed chronic respiratory failure. No patients developed renal failure. Overall, systemic ventricular (SV) function normalized in 83% of patients, whereas 17% of patients had persistent mild-to-moderate SV dysfunction. CONCLUSIONS: Intermediate-term patient survival of ECMO following CHS is encouraging. However, neurological impairment and unplanned cardiac reinterventions remain significant concerns. Further delineation of risk factors to improve patient outcomes is warranted.
Original languageEnglish (US)
Title of host publicationWorld Journal for Pediatric & Congenital Heart Surgery
Pages236-240
Number of pages5
DOIs
StatePublished - 2014

Publication series

NameWorld Journal for Pediatric & Congenital Heart Surgery
Volume5

Keywords

  • *Extracorporeal Membrane Oxygenation
  • *Heart Defects
  • Cardiac Surgical Procedures
  • Child
  • Congenital/su [Surgery]
  • Humans
  • Infant
  • Kaplan-Meier Estimate
  • Male
  • Newborn
  • Postoperative Complications/ep [Epidemiology]
  • Preschool
  • Quality of Life
  • Reoperation/sn [Statistics & Numerical Data]
  • Retrospective Studies
  • Treatment Outcome

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    Peer, S. M., Emerson, D. A., Costello, J. P., Shu, M. K., Zurakowski, D., Jonas, R. A., Berger, J. T., & Nath, D. S. (2014). Intermediate-term results of extracorporeal membrane oxygenation support following congenital heart surgery. In World Journal for Pediatric & Congenital Heart Surgery (pp. 236-240). (World Journal for Pediatric & Congenital Heart Surgery; Vol. 5). https://doi.org/10.1177/2150135113515495