HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Frank W. Bowen Alberto Pochettino Bruce R. Rosengard Rohinton J. Morris Robert C. Gorman Joseph H. Gorman, III Michael A. Acker Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Bowen, F. W. Articles by Acker, M. A. Search for Related Content PubMed PubMed Citation Articles by Bowen, F. W. Articles by Acker, M. A. Related Collections Mechanical Circulatory Assistance

Ann Thorac Surg 2001;72:86-90
© 2001 The Society of Thoracic Surgeons

---

Original article: cardiovascular

Application of "double bridge mechanical" resuscitation for profound cardiogenic shock leading to cardiac transplantation

Accepted for publication April 5, 2001.

Address reprint requests to Dr Acker, Division of Cardiothoracic Surgery, 6th Floor Silverstein, Hospital of the University Pennsylvania, 34th and Spruce St, Philadelphia, PA 19104-4283
e-mail: macker{at}mail.med.upenn.edu

Background. In patients with acute profound cardiogenic circulatory failure unresponsive to conventional resuscitation, we instituted immediate aggressive application of extracorporeal membrane oxygenation (ECMO) to restore circulatory stability. Long-term hemodynamic support was accomplished with an early "bridge" to ventricular assist device (VAD) before definitive treatment with cardiac transplantation.

Methods. A respective review of ECMO and VAD data registries was instituted.

Results. From May 1996 to July 2000, 23 patients were placed on ECMO support for profound cardiogenic circulatory failure. Eleven patients (47%) were withdrawn from support due to severe neurologic injury or multisystem organ failure. Three patients (13%) were weaned off ECMO with good outcome. Nine patients (39%) were transferred to a VAD. Two patients expired while on VAD support, and 7 of the VAD-supported patients (78%) survived to transplantation. Overall survival was 43%.

Conclusions. Emergent ECMO support is a salvage approach for cardiac resuscitation once conventional measures have failed. In neurologically intact patients, the early transfer to a VAD quickly stabilizes hemodynamics, avoids complications, and is essential for long-term circulatory support before definitive treatment with cardiac transplantation.

This article has been cited by other articles:

				M. Tajik and M. G. Cardarelli Extracorporeal membrane oxygenation after cardiac arrest in children: what do we know? Eur. J. Cardiothorac. Surg., March 1, 2008; 33(3): 409 - 417. [Abstract] [Full Text] [PDF]

				D. Hoefer, E. Ruttmann, G. Poelzl, J. Kilo, C. Hoermann, R. Margreiter, G. Laufer, and H. Antretter Outcome evaluation of the bridge to bridge concept in patients with cardiogenic shock. Ann. Thorac. Surg., July 1, 2006; 82(1): 28 - 33. [Abstract] [Full Text] [PDF]

				B. G. Leshnower, T. G. Gleason, M. L. O'Hara, A. Pochettino, Y. J. Woo, R. J. Morris, T. J. Gardner, and M. A. Acker Safety and Efficacy of Left Ventricular Assist Device Support in Postmyocardial Infarction Cardiogenic Shock Ann. Thorac. Surg., April 1, 2006; 81(4): 1365 - 1371. [Abstract] [Full Text] [PDF]

				U. Mehlhorn, M. Brieske, U. M. Fischer, M. Ferrari, P. Brass, J. H. Fischer, and H.-R. Zerkowski LIFEBRIDGE: A Portable, Modular, Rapidly Available "Plug-and-Play" Mechanical Circulatory Support System Ann. Thorac. Surg., November 1, 2005; 80(5): 1887 - 1892. [Abstract] [Full Text] [PDF]

				M. P. Anstadt and J. E. Lowe Cardiopulmonary Resuscitation Card. Surg. Adult, January 1, 2003; 2(2003): 471 - 494. [Full Text]