Could Selective Re-look Angiography Improve the Outcome of Cardiogenic Shock in Patients Under Veno-arterial Extracorporeal Membrane Oxygenator?
Maurice MaksoudAmr Salah OmarPraveen C SivadasanTamer AbdalghafoorAlaa RahhalTasnim AbdallaBassam ShomanRula TahaAbdulaziz M AlkhulaifiPublished in: Journal of cardiovascular translational research (2022)
It is not well studied whether a secondary look by angiography (Re-Ang) after fixing the culprit lesion would be beneficial or not in cardiogenic shock (CS) supported by veno-arterial extracorporeal membrane oxygenator (VA-ECMO). This study was a retrospective observational one that looked at 5-year data from a single tertiary center. Patients were grouped according to the need of Re-Ang during the VA-ECMO course into 2 groups. The indications to perform Re-Ang were loss of pulse pressure, drop in ejection fraction or velocity time integral, resistant arrhythmia, or new electrocardiographic changes suggestive of ischemia. Out of 150 patients with cardiogenic shock screened, 30 patients were enrolled in our study. Re-Ang was done in 10 patients only. In 80% of them, positive findings were found in terms of new significant stenosis (3 patients), stent restenosis (1 patient), stent thrombosis (3 patients), and patent stent(s) with intervention to the remaining lesions in other vessels (1 patient). Neither successful weaning from VA-ECMO nor mortality was statistically different between both groups. Our set indications for Re-Ang were effective in finding a possible new culprit for a conceivable coronary intervention.
Keyphrases
- ejection fraction
- end stage renal disease
- chronic kidney disease
- newly diagnosed
- peritoneal dialysis
- extracorporeal membrane oxygenation
- aortic stenosis
- randomized controlled trial
- prognostic factors
- heart failure
- cardiovascular disease
- patient reported outcomes
- angiotensin ii
- case report
- risk factors
- optical coherence tomography
- transcatheter aortic valve replacement
- machine learning
- atrial fibrillation
- pulmonary embolism
- blood flow
- data analysis