Vascular Complications in Patients with ECMO Support after Cardiac Surgery

Author:

Baran Cagdas1,Ozcinar Evren1ORCID,Kayan Ahmet2ORCID,Saricaoglu Mehmet Cahit1,Hasde Ali Ihsan1,Baran Canan Soykan3,Akar Ahmet Ruchan1ORCID,Eryilmaz Sadik1

Affiliation:

1. Department of Cardiovascular Surgery, Heart Center, Cebeci Hospitals, Ankara University School of Medicine, 06230 Ankara, Turkey

2. Department of Cardiovascular Surgery, Kirikkale High Specialization Hospital, 71300 Kirikkale, Turkey

3. Department of Cardiovascular Surgery, Ankara 29 Mayıs Hospital, 06105 Ankara, Turkey

Abstract

Background: This study assessed vascular complications in patients who received extracorporeal membrane support following cardiac surgery. Methods: We included 84 post-cardiotomy patients who underwent extracorporeal membrane oxygenation (ECMO) from July 2018 to May 2022. Only patients connected to VA-ECMO (Veno-Arterial) via peripheral cannulation were included in this study. Vascular complications were compared between those who had ECMO placed using the percutaneous technique (n = 52) and those who had it placed via femoral incision (n = 32). Results: The incidence of vascular thromboembolism was significantly higher in the percutaneous technique group compared with the open technique group (p < 0.05). Hematomas were also more frequent in the percutaneous technique group (p = 0.04). Conversely, bleeding and leakage were significantly more frequent in the open technique group (p = 0.04). There were no significant differences between the two groups in terms of wound infections or revisions in the inguinal area following ECMO removal. The mortality rate associated with vascular ischemia was 81.2%, while the overall in-hospital mortality rate was 60.7%. Conclusions: The open technique for ECMO placement may reduce the risk of thromboembolic events and hematomas compared to the percutaneous technique. However, it may be associated with a higher incidence of bleeding and leakage. Both techniques show similar outcomes in terms of overall mortality and wound infections.

Publisher

MDPI AG

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