Skip to main content

ORIGINAL RESEARCH article

Front. Cardiovasc. Med.
Sec. Cardiovascular Surgery
Volume 11 - 2024 | doi: 10.3389/fcvm.2024.1509479

The early and mid-term outcomes of acute type A aortic dissection patients with ECMO

Provisionally accepted
Qingqing Meng Qingqing Meng Hongkai Jiang Hongkai Jiang Tianbao Li Tianbao Li Shanwen Pang Shanwen Pang Chengbin Zhou Chengbin Zhou Huanlei Huang Huanlei Huang Tucheng Sun Tucheng Sun Jinlin Wu Jinlin Wu *
  • Guangdong Provincial People's Hospital, Guangzhou, China

The final, formatted version of the article will be published soon.

    Background: Acute type A aortic dissection (ATAAD) poses significant challenges in cardiovascular management due to its high morbidity and mortality rates. Postcardiotomy cardiogenic shock (PCS) is a severe complication following ATAAD repair that complicates postoperative recovery. Extracorporeal membrane oxygenation (ECMO) has emerged as a potential life-saving intervention in this context, yet the specific outcomes related to ECMO in ATAAD patients remain insufficiently studied. Methods: This retrospective single-center study reviewed the medical records of 479 patients who underwent ATAAD surgery from September 2017 to June 2021. Patients were stratified into those requiring postoperative ECMO support and those who did not. Data collected included demographics, operative details, and postoperative outcomes. Results: Of the cohort, 19 patients (4.0%) required ECMO support. The ECMO group exhibited significantly higher mortality rates (57.9% vs. 5.4%, p<0.001) and increased complications, including a higher rate of continuous renal replacement therapy (84.2% vs. 24.3%, p<0.001) and prolonged ICU stays (14.5 days vs. 7.6 days, p=0.009). Survival analysis demonstrated a stark contrast in 3-year survival rates, with 36.8% for the ECMO group versus 92.8% for non-ECMO patients (p<0.001). Conclusions: ECMO can be a crucial intervention for ATAAD patients suffering from PCS; however, it is associated with significantly higher mortality and complications. Despite lower long-term survival rates compared to non-ECMO patients, ECMO may offer a survival benefitECMO may still provide benefits as a salvage therapy. Interpretation is limited by the retrospective single-center design, small ECMO cohort size, and lack of post-discharge quality-of-life data. Future research should focus on enhancing patient selection criteria and management protocols to optimize outcomes for this high-risk population.

    Keywords: Acute type A aortic dissection, Extracorporeal membrane oxygenation (ECMO), Postcardiotomy cardiogenic shock (PCS), Aorta, Outcome

    Received: 11 Oct 2024; Accepted: 12 Dec 2024.

    Copyright: © 2024 Meng, Jiang, Li, Pang, Zhou, Huang, Sun and Wu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Jinlin Wu, Guangdong Provincial People's Hospital, Guangzhou, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.