Abstract 12692: Extracorporeal Life Support After Cardiac Intervention Provides Reasonable Survival Even in Patients With Malignancies

Abstract

Introduction: With an increasingly aging population, cardiac surgery in oncologic patients is no longer rare. In postoperative cardiopulmonary compromise, the use of extracorporeal life support after cardiac intervention (Post-cardiac ECLS) has increased in general but its efficacy in oncologic patients is not clear. Hypothesis: ECLS after cardiac intervention provides reasonable survival in patients with malignancies. Methods: The Extracorporeal Life Support Organization registry was queried for patients older than 18 years with an International Classification of Diseases codes of hematologic and solid malignancy over the last decade (2010-2019). Among them, patients who underwent cardiac surgery or transcatheter valve intervention were selected. Outcomes and clinical data including types of procedure and cancer subtypes were analyzed. Results: One hundred and sixty-two patients met inclusion criteria: 17 pulmonary ECLS, 119 cardiac ECLS, and 26 extracorporeal cardiopulmonary resuscitation. Sixty-two patients (38.3 %) survived to discharge, which was significantly worse than all adult ECLS runs over the same time period (49.0%). Among subtypes, hematologic (p=0.041) and breast cancer (p=0.023) were associated with worse prognosis in comparison with all adult ECLS runs. Coronary artery bypass grafting (n=56) and surgical valve procedure (n=54) were dominant types of the procedure with a survival of 44.6% and 33.3%, respectively. Ventricular assist device procedure (n=48) and cardiac transplant (n=21) were also commonly performed with a survival of 37.5% and 33.3%, respectively. Conclusions: Use of Post-cardiac ECLS in oncologic patients has been increasing. Considering the poor outcomes reported in ECLS for postcardiotomy shock in general, our observed survival rate seems reasonable and should not exclude this population from ECLS consideration, with careful patient selection.