VA ECMO as a bridge to OHT in the sickest of the sick cardiogenic shock patients

Title : VA ECMO as a bridge to OHT in the sickest of the sick cardiogenic shock patients

Abstract:

To show the utility and benefit of VA-ECMO support in adults as a bridge to cardiac transplantation in the sickest of the sick cardiogenic shock patient population. VA-ECMO as bridge to LVAD or HT has significantly increased last 10-years. This approach has been controversial given poor outcomes (historically). Retrospective analysis of the ELSO registry reports in-hospital mortality at 29.1%. The graphic shows the growth of cardiac transplantation off of VA-ECMO is about 15%.

A more aggressive approach to VA-ECMO support in cardiogenic shock patients who were deemed acceptable for cardiac transplantation was begun in November 2022. As of November 2024, our center has performed 34 cardiac transplants off of VA -ECMO support. Survival to hospital discharge is 97%, (33/34). The median duration of hospital stay post-transplant was 23 days, (17-29). The one-year survival of this cardiac transplantation population is 94%, (32/34). The causes of death in these two patients were graft rejection and a CVA.

Biography:

PW Barrett, MD, MS FACS is a board-certified General Surgeon, Adult Cardiothoracic Surgeon and Surgical Critical Care/ Trauma Physician.  He is the Director of Cardiovascular Critical Care and ECMO at Piedmont Atlanta Hospital and Piedmont Heart Institute in Atlanta Georgia, USA. He has over thirty years’ experience in the MCS field.