52. Early revascularization on veno-arterial ECMO for patients with cardiogenic shock post stemi

Abstract

Refractory Cardiogenic shock (CS) complicates 5–7% of cases of ST-elevation myocardial infarction (STEMI), and is a leading cause of hospital death after myocardial infarction. CS complicating acute myocardial infarction continues to have a high mortality of 60–80% despite early revascularization and adjunctive therapies. We studied the effectiveness of veno-arterial (VA) – Extracorporeal Membrane Oxygenator (ECMO) for the patients with CS post STEMI during coronary angiography at our institute. Between January 2014 to April 2015, 8 male patients who suffered from progressive severe refractory CS post STEMI underwent emergent peripheral VA-ECMO implantation while performing cardiopulmonary resuscitation during coronary angiography. 7 patients of underwent PCI, while 1 patient was not amenable to PCI or CABG. The mean duration of support was 8.5 ± 5.8 days. 6 patients were successfully weaned from ECMO. While on ECMO support, 2 patients died. Mean EF after ECMO explantation was 32.5% ± 10.5%. The 30-day survival was 50%. Early revascularization on ECMO allows supporting hemodynamic efficiently in cardiogenic shock patients.