Venoarterial extracorporeal membrane oxygenation with or without simultaneous intra-aortic balloon pump support as a direct bridge to heart transplantation: results from a nationwide Spanish registry

Objectives: To investigate the potential clinical benefit of an intra-aortic balloon pump (IABP) in patients supported with venoarterial extracorporeal membrane oxygenation (VA-ECMO) as a bridge to heart transplantation (HT). Methods: We studied 169 patients who were listed for urgent HT under VA-EC...

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Autores: Barge-Caballero, Gonzalo, Castel-Lavilla, María A., Almenar-Bonet, Luis, Garrido-Bravo, Iris P., Delgado, Juan F., Rangel-Sousa, Diego, González-Costello, José, Segovia-Cubero, Javier, Farrero-Torres, Marta, Lambert-Rodríguez, José Luis, Crespo-Leiro, María G., Hervás-Sotomayor, Daniela, Portolés-Ocampo, Ana, Martínez-Sellés, Manuel, De la Fuente-Galán, Luis, Rábago-Juan-Aracil, Gregorio, González Vílchez, Francisco Jesús, Mirabet-Pérez, Sonia, Muñiz, Javier, Barge-Caballero, Eduardo
Tipo de recurso: artículo
Fecha de publicación:2019
País:España
Institución:Universidad de Cantabria (UC)
Repositorio:UCrea Repositorio Abierto de la Universidad de Cantabria
Idioma:inglés
OAI Identifier:oai:repositorio.unican.es:10902/36185
Acceso en línea:https://hdl.handle.net/10902/36185
Access Level:acceso abierto
Palabra clave:Heart transplantation
Extracorporeal membrane oxygenation
Intra-aortic balloon pump
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spelling Venoarterial extracorporeal membrane oxygenation with or without simultaneous intra-aortic balloon pump support as a direct bridge to heart transplantation: results from a nationwide Spanish registryBarge-Caballero, GonzaloCastel-Lavilla, María A.Almenar-Bonet, LuisGarrido-Bravo, Iris P.Delgado, Juan F.Rangel-Sousa, DiegoGonzález-Costello, JoséSegovia-Cubero, JavierFarrero-Torres, MartaLambert-Rodríguez, José LuisCrespo-Leiro, María G.Hervás-Sotomayor, DanielaPortolés-Ocampo, AnaMartínez-Sellés, ManuelDe la Fuente-Galán, LuisRábago-Juan-Aracil, GregorioGonzález Vílchez, Francisco JesúsMirabet-Pérez, SoniaMuñiz, JavierBarge-Caballero, EduardoHeart transplantationExtracorporeal membrane oxygenationIntra-aortic balloon pumpObjectives: To investigate the potential clinical benefit of an intra-aortic balloon pump (IABP) in patients supported with venoarterial extracorporeal membrane oxygenation (VA-ECMO) as a bridge to heart transplantation (HT). Methods: We studied 169 patients who were listed for urgent HT under VA-ECMO support at 16 Spanish institutions from 2010 to 2015. The clinical outcomes of patients under simultaneous IABP support (n=73) were compared to a control group of patients without IABP support (n=96). Results: There were no statistically significant differences between the IABP and control groups with regard to the cumulative rates of transplantation (71.2% vs 81.2%, P=0.17), death during VA-ECMO support (20.6% vs 14.6%, P=0.31), transition to a different mechanical circulatory support device (5.5% vs 5.2%, P=0.94) or weaning from VA-ECMO support due to recovery (2.7% vs 0%, P=0.10). There was a higher incidence of bleeding events in the IABP group (45.2% vs 25%, P=0.006; adjusted odds ratio 2.18, 95% confidence interval 1.02-4.67). In-hospital postoperative mortality after HT was 34.6% in the IABP group and 32.5% in the control group (P=0.80). One-year survival after listing for urgent HT was 53.3% in the IABP group and 52.2% in the control group (log rank P=0.75). Multivariate adjustment for potential confounders did not change this result (adjusted hazard ratio 0.94, 95% confidence interval 0.56-1.58). Conclusions: In our study, simultaneous IABP therapy in transplant candidates under VA-ECMO support did not significantly reduce morbidity or mortality.Funding: This study was funded by a research grant from the Fundación Mutua Madrileña, Madrid, Spain. A few investigators of this study are affiliated with the Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV) of the Instituto de Salud Carlos III. Acknowledgements: The authors are grateful to the staff of the Organizacio´ n Nacional de Trasplantes (ONT) for their collaboration in this study.Oxford University PressUniversidad de Cantabria20192019-01-01journal articlehttp://purl.org/coar/resource_type/c_6501NAhttp://purl.org/coar/version/c_be7fb7dd8ff6fe43info:eu-repo/semantics/articlehttps://hdl.handle.net/10902/36185Interactive Cardiovascular and Thoracic Surgery, 2019, 29(5), 670-677reponame:UCrea Repositorio Abierto de la Universidad de Cantabriainstname:Universidad de Cantabria (UC)Inglésengopen accesshttp://purl.org/coar/access_right/c_abf2Attribution-NonCommercial 4.0 Internationalhttp://creativecommons.org/licenses/by-nc/4.0/info:eu-repo/semantics/openAccessoai:repositorio.unican.es:10902/361852026-06-02T12:39:31Z
dc.title.none.fl_str_mv Venoarterial extracorporeal membrane oxygenation with or without simultaneous intra-aortic balloon pump support as a direct bridge to heart transplantation: results from a nationwide Spanish registry
title Venoarterial extracorporeal membrane oxygenation with or without simultaneous intra-aortic balloon pump support as a direct bridge to heart transplantation: results from a nationwide Spanish registry
spellingShingle Venoarterial extracorporeal membrane oxygenation with or without simultaneous intra-aortic balloon pump support as a direct bridge to heart transplantation: results from a nationwide Spanish registry
Barge-Caballero, Gonzalo
Heart transplantation
Extracorporeal membrane oxygenation
Intra-aortic balloon pump
title_short Venoarterial extracorporeal membrane oxygenation with or without simultaneous intra-aortic balloon pump support as a direct bridge to heart transplantation: results from a nationwide Spanish registry
title_full Venoarterial extracorporeal membrane oxygenation with or without simultaneous intra-aortic balloon pump support as a direct bridge to heart transplantation: results from a nationwide Spanish registry
title_fullStr Venoarterial extracorporeal membrane oxygenation with or without simultaneous intra-aortic balloon pump support as a direct bridge to heart transplantation: results from a nationwide Spanish registry
title_full_unstemmed Venoarterial extracorporeal membrane oxygenation with or without simultaneous intra-aortic balloon pump support as a direct bridge to heart transplantation: results from a nationwide Spanish registry
title_sort Venoarterial extracorporeal membrane oxygenation with or without simultaneous intra-aortic balloon pump support as a direct bridge to heart transplantation: results from a nationwide Spanish registry
dc.creator.none.fl_str_mv Barge-Caballero, Gonzalo
Castel-Lavilla, María A.
Almenar-Bonet, Luis
Garrido-Bravo, Iris P.
Delgado, Juan F.
Rangel-Sousa, Diego
González-Costello, José
Segovia-Cubero, Javier
Farrero-Torres, Marta
Lambert-Rodríguez, José Luis
Crespo-Leiro, María G.
Hervás-Sotomayor, Daniela
Portolés-Ocampo, Ana
Martínez-Sellés, Manuel
De la Fuente-Galán, Luis
Rábago-Juan-Aracil, Gregorio
González Vílchez, Francisco Jesús
Mirabet-Pérez, Sonia
Muñiz, Javier
Barge-Caballero, Eduardo
author Barge-Caballero, Gonzalo
author_facet Barge-Caballero, Gonzalo
Castel-Lavilla, María A.
Almenar-Bonet, Luis
Garrido-Bravo, Iris P.
Delgado, Juan F.
Rangel-Sousa, Diego
González-Costello, José
Segovia-Cubero, Javier
Farrero-Torres, Marta
Lambert-Rodríguez, José Luis
Crespo-Leiro, María G.
Hervás-Sotomayor, Daniela
Portolés-Ocampo, Ana
Martínez-Sellés, Manuel
De la Fuente-Galán, Luis
Rábago-Juan-Aracil, Gregorio
González Vílchez, Francisco Jesús
Mirabet-Pérez, Sonia
Muñiz, Javier
Barge-Caballero, Eduardo
author_role author
author2 Castel-Lavilla, María A.
Almenar-Bonet, Luis
Garrido-Bravo, Iris P.
Delgado, Juan F.
Rangel-Sousa, Diego
González-Costello, José
Segovia-Cubero, Javier
Farrero-Torres, Marta
Lambert-Rodríguez, José Luis
Crespo-Leiro, María G.
Hervás-Sotomayor, Daniela
Portolés-Ocampo, Ana
Martínez-Sellés, Manuel
De la Fuente-Galán, Luis
Rábago-Juan-Aracil, Gregorio
González Vílchez, Francisco Jesús
Mirabet-Pérez, Sonia
Muñiz, Javier
Barge-Caballero, Eduardo
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Universidad de Cantabria
dc.subject.none.fl_str_mv Heart transplantation
Extracorporeal membrane oxygenation
Intra-aortic balloon pump
topic Heart transplantation
Extracorporeal membrane oxygenation
Intra-aortic balloon pump
description Objectives: To investigate the potential clinical benefit of an intra-aortic balloon pump (IABP) in patients supported with venoarterial extracorporeal membrane oxygenation (VA-ECMO) as a bridge to heart transplantation (HT). Methods: We studied 169 patients who were listed for urgent HT under VA-ECMO support at 16 Spanish institutions from 2010 to 2015. The clinical outcomes of patients under simultaneous IABP support (n=73) were compared to a control group of patients without IABP support (n=96). Results: There were no statistically significant differences between the IABP and control groups with regard to the cumulative rates of transplantation (71.2% vs 81.2%, P=0.17), death during VA-ECMO support (20.6% vs 14.6%, P=0.31), transition to a different mechanical circulatory support device (5.5% vs 5.2%, P=0.94) or weaning from VA-ECMO support due to recovery (2.7% vs 0%, P=0.10). There was a higher incidence of bleeding events in the IABP group (45.2% vs 25%, P=0.006; adjusted odds ratio 2.18, 95% confidence interval 1.02-4.67). In-hospital postoperative mortality after HT was 34.6% in the IABP group and 32.5% in the control group (P=0.80). One-year survival after listing for urgent HT was 53.3% in the IABP group and 52.2% in the control group (log rank P=0.75). Multivariate adjustment for potential confounders did not change this result (adjusted hazard ratio 0.94, 95% confidence interval 0.56-1.58). Conclusions: In our study, simultaneous IABP therapy in transplant candidates under VA-ECMO support did not significantly reduce morbidity or mortality.
publishDate 2019
dc.date.none.fl_str_mv 2019
2019-01-01
dc.type.none.fl_str_mv journal article
http://purl.org/coar/resource_type/c_6501
NA
http://purl.org/coar/version/c_be7fb7dd8ff6fe43
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://hdl.handle.net/10902/36185
url https://hdl.handle.net/10902/36185
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution-NonCommercial 4.0 International
http://creativecommons.org/licenses/by-nc/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution-NonCommercial 4.0 International
http://creativecommons.org/licenses/by-nc/4.0/
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv Oxford University Press
publisher.none.fl_str_mv Oxford University Press
dc.source.none.fl_str_mv Interactive Cardiovascular and Thoracic Surgery, 2019, 29(5), 670-677
reponame:UCrea Repositorio Abierto de la Universidad de Cantabria
instname:Universidad de Cantabria (UC)
instname_str Universidad de Cantabria (UC)
reponame_str UCrea Repositorio Abierto de la Universidad de Cantabria
collection UCrea Repositorio Abierto de la Universidad de Cantabria
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,811543

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