Boston - American Association for Thoracic Surgery

AMERICAN ASSOCIATION FOR THORACIC SURGERYL7. Temporary Acute Mechanical Circulatory Support for AcuteCirculatory Collapse: Experience with 266 PatientsKristopher B. Deatrick, Amit K. Mathur, Ann Schumar, Robert H. Bartlett,Francis D. Pagani, * Jonathan W. HaftCardiac Surgery, The University of Michigan, Ann Arbor, MI, USAOBJECTIVE: Temporary mechanical circulatory support can be offered to patients inshock refractory to medical treatment. This report reviews our experience withseveral support systems with respect to early, midterm, and late outcome, andassesses predictors of mortality.METHODS: We systematically reviewed the records of patients 16 years of age andolder who received temporary mechanical support due to acute circulatory collapse.Three modes of support were used: venoarterial extracorporeal membraneoxygenation (ECMO), ABIOMED ventricular assist device (VAD) systems, or theTandemHeart percutaneous VAD. Circulatory support was used for circulatorycollapse due one of the following: acute myocardial infarction (AMI) n = 61 (23%),post-cardiotomy failure n = 34 (13%), pulmonary embolism (PE) n = 13 (5%), cardiomyopathy(CM) n = 77 (29%), sepsis n = 22 (8%), other acute heart failure n =28 (11%), or heart or lung transplant graft dysfunction (GD) n = 17 (6%). Mortalitywas confirmed using the Social Security Death Index. Survival was estimated usingthe Kaplan-Meier method. Risk-adjusted in-hospital mortality was determinedusing Cox proportional-hazards models.SUNDAYAfternoonRESULTS: From 1997–2008, 278 patients at our center have received temporarycirculatory support; 266 patients had sufficient data available for analysis. Meanage of patients was 47.5 ± 14.1 years. 60% (n = 159) of patients were male. Averageduration on acutely placed support was 5.2 ± 5.6 days. 57% (n = 154) of patientswere successfully weaned. Survival to discharge was 40% (n = 113). Of patientswho survived to discharge, median survival was 235 days. 26% of patients (n = 68)* AATS Member65