Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Dec;43(8):1811-1821.
doi: 10.1007/s00246-022-02918-9. Epub 2022 May 9.

Outcomes of Extracorporeal Membrane Oxygenation in Patients After Repair of Congenital Heart Defects

Serdar Basgoze  1   2 , Bahar Temur  3 , Selim Aydın  3 , Fusun Guzelmeric  4 , Osman Guvenc  5 , Ayhan Cevik  5 , Muzeyyen Iyigun  4 , Ersin Erek  3
Affiliations

Outcomes of Extracorporeal Membrane Oxygenation in Patients After Repair of Congenital Heart Defects

Serdar Basgoze et al. Pediatr Cardiol. 2022 Dec.

Abstract

Extracorporeal membrane oxygenation (ECMO) is widely used after congenital heart surgery. The purpose of this study is to analyze the factors influencing mortality and morbidity in patients who require ECMO support after congenital cardiac surgery. All 109 patients (5.8% of total cases) who underwent ECMO support after congenital heart surgery between January 2014 and 2021 were included in this single-center study. The mean age was 10.13 ± 20.55 months, and the mean weight was 6.41 ± 6.79 kg. 87 (79.8%) of the patients were under 1 year of age. A total of 54 patients (49.5%) were weaned successfully from ECMO support, and 27 of them (24.8%) were discharged. The childhood age group had the best outcomes. Seventy-seven percent of the children were weaned successfully, and 50% were discharged. 69 patients (63.3%) had biventricular physiology; weaning and survival outcomes were better than single ventricle patients (P-value 0.002 and < 0.001, respectively). Low cardiac output (n = 49; 44.9%) as an ECMO indication had better outcomes than extracorporeal cardiopulmonary resuscitation (n = 31; 28.4%) (P = 0.05). Most of the patients had ≥ 4 Modified Aristotle Comprehensive Complexity (MACC) levels, and higher MACC levels were associated with a higher mortality rate. The most common procedure was the Norwood operation (16.5%), with the worst outcome (5.5% survival). Bleeding and renal complications were the most common complications affecting outcomes. Results were more satisfactory in patients with biventricular repair, childhood, and lower MACC levels. Early initiation of ECMO in borderline patients without experiencing cardiac arrest or multiorgan failure may improve outcomes.

Keywords: Congenital; Extracorporeal membrane oxygenation; Pediatric.

PubMed Disclaimer

References

    1. Brunetti MA, Gaynor JW, Retzloff LB, Lehrich JL, Banerjee M, Amula V, Bailly D, Klugman D, Koch J, Lasa J, Pasquali SK, Gaies M (2018) Characteristics, risk factors, and outcomes of extracorporeal membrane oxygenation use in pediatric cardiac ICUs: a report from the pediatric cardiac critical care consortium registry. Pediatr Crit Care Med 19(6):544–552. https://doi.org/10.1097/PCC.0000000000001571 - DOI - PubMed - PMC
    1. Bratton SL, Chan T, Barrett CS, Wilkes J, Ibsen LM, Thiagarajan RR (2017) Metrics to assess extracorporeal membrane oxygenation utilization in pediatric cardiac surgery programs. Pediatr Crit Care Med 18(8):779–786. https://doi.org/10.1097/PCC.0000000000001205 - DOI - PubMed
    1. Ergün S, Yildiz O, Güneş M, Akdeniz HS, Öztürk E, Onan İS, Güzeltaş A, Haydin S (2020) Use of extracorporeal membrane oxygenation in postcardiotomy pediatric patients: parameters affecting survival. Perfusion 35(7):608–620. https://doi.org/10.1177/0267659119897746 - DOI - PubMed
    1. Mascio CE, Austin EH 3rd, Jacobs JP, Jacobs ML, Wallace AS, He X, Pasquali SK (2014) Perioperative mechanical circulatory support in children: an analysis of the society of thoracic surgeons congenital heart surgery database. J Thorac Cardiovasc Surg 147(2):658–64. https://doi.org/10.1016/j.jtcvs.2013.09.075 (discussion 664–5) - DOI - PubMed
    1. Kumar TK, Zurakowski D, Dalton H, Talwar S, Allard-Picou A, Duebener LF, Sinha P, Moulick A (2010) Extracorporeal membrane oxygenation in postcardiotomy patients: factors influencing outcome. J Thorac Cardiovasc Surg 140(2):330-336.e2. https://doi.org/10.1016/j.jtcvs.2010.02.034 - DOI - PubMed

LinkOut - more resources