Hernández-Zamonsett, Diego; Arellano-Juárez, Leonardo; Payro-Hernández, Luis E; Zetina-Tun, Hugo J; Lezama-Urtecho, Carlos A

ABSTRACT

Objective: Veno-Arterial (VA) Extracorporeal Membrane Oxygenation (ECMO) for refractory postcardiotomy cardiogenic shock carries high mortality. The objective was to describe the frequency of mortality and complications in adult patients who required this support after cardiac surgery, as well as the associated factors. Material and methods: an observational, descriptive, retrospective study. Records of 30 patients undergoing cardiac surgery requiring VA ECMO support at the “Dr. Gaudencio González Garza” General Hospital between January 1, 2013, and December 31, 2023, were analyzed. Demographic, surgical and complication variables were compared between survivors and non-survivors using t-Student and χ² tests. Results: thirty patients were included, with a mean age of 44.8 years; 80% were cardiac transplants. Overall mortality was 63.3% (n = 19). The most frequent complications were acute kidney injury (66.7%) and bleeding (60%). No significant differences were found in age (p = 0.14) or support duration (5.73 vs 5.78 days, p = 0.97). Pre-support Left Ventricular Ejection Fraction (LVEF) was the only variable with statistical significance, being paradoxically higher in the deceased group (mean 34.4%) compared to survivors (mean 27.4%) (p = 0.031). Conclusions: mortality for postcardiotomy VA ECMO in our cohort (63.3%) is high, consistent with international reports. Renal failure and bleeding were the predominant complications. Pre-support LVEF was not a predictor of survival; its paradoxical association with mortality suggests that other perioperative factors are more determinant.

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