Trends In The Use Of Va-ecmo In The Management Of Post Infarction Ventricular Septal Defect

Abstract

<h3>Introduction</h3> Myocardial infarction resulting in a post-infarction ventricular septal defect (PIVSD) is an infrequent but detrimental event resulting in high morbidity and mortality rates. This complication can be particularly devastating in the setting of cardiogenic shock, which can complicate definitive surgical or transcatheter treatment of the condition. Veno-Arterial Extra-Corporeal Membrane Oxygenation (VA-ECMO) is a form of mechanical circulatory support that can be used to support such patients and guide decisions on definitive therapy. Our study aimed to assess the role of VA-ECMO in management of patients with PIVSD. <h3>Methods</h3> Data in the form of ELSO variables was requested from the Extra Corporeal Life Support Organization (ELSO) registry. The study period was from year 2000 to 2018. Inclusion criteria were a diagnosis of Ventricular septal defect as current complication following acute myocardial infarction, VA ECMO, and age 18-100. Exclusion criteria were VV ECMO, Age less than 18 years old, and Non-VSD. <h3>Results</h3> 189 patients met study criteria. 28%(n=53) patients were female, and the median age was 63 years. In terms of race, 72%(n=136) were white,8% (n=16) were Asian, 6% (n=12) were Hispanic and 2% (n=4) were Black. 30% patients (n= 57) were reported to be alive at discharge. <h3>Conclusion</h3> VA-ECMO can be used to support patients with Post Infarction Ventricular Septal Defect. This condition continues to have a high mortality rate with 30% survival noted in our study. There was poor representation of females and racial minorities in the study population.