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Related Concept Videos

Cardiomyopathy VII: Pre and Post Operative Nursing Management01:28

Cardiomyopathy VII: Pre and Post Operative Nursing Management

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Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
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ECMO POST-CARDIOTOMY, A SINGLE CENTRE EXPERIENCE.

Daniela Gouveia1, José Máximo1, Nuno Costa1

  • 1Cardiothoracic Surgery Department - Centro Hospitalar Universitário de São João, Portugal.

Portuguese Journal of Cardiac Thoracic and Vascular Surgery
|April 9, 2021
PubMed
Summary
This summary is machine-generated.

Extracorporeal membrane oxygenation (ECMO) after cardiac surgery can save lives, with one in three patients experiencing refractory cardiogenic shock surviving. Survivors of this advanced cardiopulmonary support generally maintain good health, despite associated risks.

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Area of Science:

  • Cardiology
  • Cardiothoracic Surgery
  • Intensive Care Medicine

Background:

  • Refractory cardiogenic shock post-cardiotomy presents a critical challenge in cardiac surgery.
  • Extracorporeal membrane oxygenation (ECMO) is an advanced life support option for such severe cases.

Purpose of the Study:

  • To evaluate the outcomes of veno-arterial (VA) ECMO in patients with refractory cardiogenic shock following cardiac surgery at Centro Hospitalar Universitário S. João (CHUSJ).

Main Methods:

  • A retrospective analysis of 13 adult patients who underwent VA ECMO for post-cardiotomy cardiogenic shock between 2011 and 2019.
  • Data collected included preoperative comorbidities, surgical details, ECMO parameters, postoperative complications, and mortality.
  • Survival rates at 12, 36, and 60 months post-discharge were assessed.

Main Results:

  • Seven patients (53.8%) were successfully decannulated after a median ECMO duration of 6 days.
  • Overall hospital mortality was 61.5% (8 patients).
  • Five patients (38.5%) survived, with 4 discharged home; long-term survival at 60 months was 8.3%.

Conclusions:

  • Veno-arterial ECMO offers a life-saving option for approximately one-third of patients with refractory cardiogenic shock post-cardiac surgery.
  • Despite significant risks, survivors of VA ECMO can achieve and maintain a good health status.