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Temporary biventricular support with extracorporeal membrane oxygenation: a feasible therapeutic approach for cardiogenic shock with multiple organ failure

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  • Artificial Heart (Clinical)
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Abstract

Various strategies using a ventricular assist device (VAD) are applied to rescue Interagency Registry for Mechanically Assisted Circulatory Support profile 1 (Profile-1) patients. However, the optimal use of VAD in Profile-1 patients has not been completely elucidated. We retrospectively reviewed 23 Profile-1 patients [mean age 36.9 ± 16.6 years, 14 males; 11 with non-ischemic cardiomyopathy (NICM), 9 with fulminant myocarditis (FM), 2 with ischemic cardiomyopathy (ICM), and 1 with peripartum cardiomyopathy (PPCM); 18 with pre-operative percutaneous extracorporeal membrane oxygenation (p-ECMO) support] who underwent VAD implantation from 2011 to 2015 at our institution. Nine initially received left VAD (LVAD) alone (NICM in 9, ICM in 2 with ICM, and FM in 1), one with NICM received biventricular VAD (BiVAD; n = 1), and 10 received LVAD combined with right ventricular support using an ECMO circuit (BiVAD-ECMO) (FM in 8, NICM in 1, and PPCM in 1). Paracorporeal VAD was used in all patients. ECMO was used for the patients with severe pulmonary edema, inflammation, anemia, and thrombopenia. The BiVAD patient died 1.4 months after VAD implantation. The overall survival was comparable between patients with BiVAD-ECMO and LVAD (2-year survival, 80.0 and 75.0%, respectively). Three VAD strategies were initially applied in Profile-1 patients. Among them, the BiVAD-ECMO strategy is a promising therapeutic option to rescue Profile-1 patients with multiple organ failure.

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Acknowledgements

We thank Yuzo Takahashi, Hideki Yotsuida, Hiroshi Nishioka, Megumi Komiyama, Rieko Sakai, Eri Miyoshi, Ai Nagayo, Nobuaki Konishi, Shiho Tsuboi, and Yumiko Hori for their roles in providing patient care.

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Authors and Affiliations

  1. Department of Transplantation, National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka, 565-8565, Japan

    Osamu Seguchi, Takuya Watanabe, Kensuke Kuroda, Eriko Hisamatsu, Seiko Nakajima, Takuma Sato, Haruki Sunami, Masanobu Yanase, Takeshi Nakatani & Norihide Fukushima

  2. Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka, 565-8565, Japan

    Tomoyuki Fujita, Hiroki Hata & Junjiro Kobayashi

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  1. Osamu Seguchi
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  2. Tomoyuki Fujita
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  3. Takuya Watanabe
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  4. Kensuke Kuroda
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  5. Eriko Hisamatsu
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  7. Takuma Sato
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  8. Haruki Sunami
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  9. Masanobu Yanase
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  11. Junjiro Kobayashi
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  12. Takeshi Nakatani
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  13. Norihide Fukushima
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Correspondence to Osamu Seguchi or Norihide Fukushima.

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Seguchi, O., Fujita, T., Watanabe, T. et al. Temporary biventricular support with extracorporeal membrane oxygenation: a feasible therapeutic approach for cardiogenic shock with multiple organ failure. J Artif Organs 20, 206–214 (2017). https://doi.org/10.1007/s10047-017-0966-5

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  • DOI: https://doi.org/10.1007/s10047-017-0966-5

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