Analysis of clinical outcome and early death risk factors of patients after cardiac surgery assisted by VA-ECMO

Zhao Shuai; Wu Rui; Liu Zhigang

doi:10.3969/j.issn.1674-4055.2025.01.19

Abstract：Objective To summarize the early clinical outcome of veno-arterial ECMO(VA-ECMO)in patients after cardiac surgery,and analyze the risk factors of early death.Method The clinical data of 44 patients who received VA-ECMO support after cardiac surgery in TEDA International Cardiovascular Hospital from January 2018 to December 2021 were collected,and the early outcome of VA-ECMO support and the risk factors of early death were analyzed.Result Forty-four patients were assisted by ECMO after surgery,with an average age of 63.45±11.25 years,including 28 males(63.6%)and 24 offline patients(54.5%).Sixteen patients survived,with an overall survival rate of 36.4%.The main diagnosis is coronary atherosclerotic heart disease(coronary heart disease)and valvular heart disease.The ECMO assisting time in the survival group and the death group was 189.50 h(113.00,248.50)and 121.50 h(38.50,240.50)respectively,with statistical significance(P=0.00).The ICU time and hospitalization time in the survival group were longer than those in the death group(P<0.05),and there was no significant difference between the two groups in terms of gender,weight,complications,operation mode,cardiopulmonary bypass time,aortic occlusion time and hemodynamics during boarding(P>0.05).There were significant differences in age,ejection fraction(EF),left ventricular end diastolic volume(LVEDV),creatinine(Cr),hemodynamics during weaning and lactic acid(Lac)during weaning(P<0.05).Multivariate analysis showed that preoperative renal insufficiency,left ventricular ejection fraction(LVEF),Cr,intra-aortic balloon pump(IABP)were independent risk factors affecting the assisted outcome.Conclusion VA-ECMO is effective in assisting critically ill patients after cardiac surgery.Preoperative renal function,EF,Cr and whether IABP is combined or not are independent factors that affect the perioperative auxiliary outcome of adult cardiac surgery patients.