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Efficacy of extracorporeal membrane oxygenation in a congenital heart surgery program
Jörg S Sachweh1, Andreas R Tiete, Alexandra Fuchs
1Pediatric Cardiac Surgery, University Hospital, Aachen, Germany. jsachweh@ukaachen.de
Insights
Extracorporeal membrane oxygenation (ECMO) significantly improves survival rates for pediatric congenital heart surgery patients experiencing circulatory failure. This life-support technology offers midterm clinical well-being for half of treated individuals.
Area of Science:
- Pediatric Cardiology
- Cardiothoracic Surgery
- Mechanical Circulatory Support
Background:
- Extracorporeal membrane oxygenation (ECMO) is a vital life support technique.
- Its application in congenital heart surgery programs requires careful evaluation.
- Reporting institutional experience with ECMO in this patient population is crucial.
Purpose of the Study:
- To detail the clinical experience with ECMO in a congenital heart surgery program.
- To assess the efficacy and outcomes of ECMO as circulatory support.
- To evaluate the midterm results and survival rates in pediatric patients.
Main Methods:
- Retrospective analysis of 24 patients (neonates to adults) receiving ECMO since 1996.
- ECMO was primarily used for failure to wean from cardiopulmonary bypass.
- Patient demographics, support duration, and outcomes were recorded.
Main Results:
- Mean ECMO support duration was 3.8 days.
- 50% of patients (12/24) were discharged and remain clinically well long-term.
- Mortality causes included multiorgan failure and myocardial failure.
Conclusions:
- ECMO significantly reduces mortality in patients with severe heart conditions.
- It provides a crucial bridge for survival after complex cardiac procedures.
- Midterm follow-up shows no discernible morbidity associated with ECMO use.
Background:
To report our experience with extracorporeal membrane oxygenation (ECMO) in a congenital heart surgery program.
Methods:
Since 12/1996, 24 patients (8 newborns, 9 infants, 3 children, 4 adolescents/ adults 17-23 years), mean age 4.0+/-7.4 years (2 days-23 years), body weight 2.7-87 kg had ECMO as circulatory support. Indication was failure to wean from cardiopulmonary bypass in the majority of cases.
Results:
Mean duration of support was 3.8+/-2.9 d (12 h-13 d). Fourteen patients were weaned from ECMO (9 discharged), three successfully transplanted (one after switching to a pulsatile assist device). One patient on left-ventricular support required ECMO for sudden right ventricular failure (decreased). There were six deaths on ECMO due to multiorgan failure (MOV) (3) or no myocardial recovery (3). Six patients died after weaning (3 MOV, 2 myocardial failure, 1 fungal sepsis). Overall, twelve patients (50%) were discharged and are clinically well after 3.4+/-2.4 years (0.8-7.2 years).
Conclusion:
In our series, ECMO markedly reduces mortality in patients who would otherwise not survive either open heart surgery or myocardial failure of any origin and was not associated with discernible morbidity in the midterm.