Intermediate-Term Results of Extracorporeal Membrane Oxygenation Support Following Congenital Heart Surgery

Authors

Syed Murfad Peer, Children's National Medical Center
Dominic A. Emerson, Children's National Medical Center
John P. Costello, Children's National Medical Center
Michael K. Shu, George Washington UniversityFollow
David Zurakowski, Harvard University
Richard A. Jonas, Children's National Medical CenterFollow
John T. Berger, Children's National Medical CenterFollow
Dilip S. Nath, Children's National Medical CenterFollow

Document Type

Poster

Publication Date

4-2-2014

Abstract

Background: Although there are considerable data regarding in-hospital results of congenital heart surgery patients requiring post-operative extracorporeal membrane oxygenation support, there is limited information on intermediate-term outcomes.

Methods: A single institution retrospective review of 25 consecutive post-operative congenital heart surgery patients who required extracorporeal membrane oxygenation and survived to hospital discharge between January 2003 and June 2008. Survival was estimated by the Kaplan-Meier method.

Results: At a median follow-up of 3.3 years (interquartile range: 1.2-5.9 years), there was 1 death which occurred at 6 months post-surgery. Kaplan-Meier estimated survival at 3 years was 95% (95% confidence interval: 90-100%). Indications for extracorporeal membrane oxygenation included extracorporeal cardiopulmonary resuscitation (48%), systemic hypoxia (4%), post-operative low cardiac output syndrome (28%), and intra-operative failure to wean off of cardiopulmonary bypass (20%). Following extracorporeal membrane oxygenation support, 65% of patients had unplanned cardiac re-interventions (3 requiring operative interventions, 6 requiring percutaneous interventions, and 4 requiring both), and 47% required unplanned hospitalizations. 29% developed neurological deficits, and 12% developed chronic respiratory failure. No patients developed renal failure. Overall systemic ventricular function normalized in 83% of patients, whereas 17% had persistent mild-to-moderate systemic ventricular dysfunction.

Conclusions: Intermediate-term patient survival of extracorporeal membrane oxygenation following congenital heart surgery is encouraging. However, neurological impairment and unplanned cardiac re-interventions remain significant concerns. Further delineation of risk factors to improve patient outcomes is warranted.

Comments

Presented at: George Washington University Research Days 2014.

Recommended Citation

Peer, Syed Murfad; Emerson, Dominic A.; Costello, John P.; Shu, Michael K.; Zurakowski, David; Jonas, Richard A.; Berger, John T.; and Nath, Dilip S., "Intermediate-Term Results of Extracorporeal Membrane Oxygenation Support Following Congenital Heart Surgery" (2014). GW Research Days 2014. Paper 5.
https://hsrc.himmelfarb.gwu.edu/researchdays_2014/5

Open Access

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