| Abstract [eng] |
Postcardiotomy shock (PCS) complicates 1.5–6% of all cardiac surgeries, with the in-hospital mortality rate being as high as 67%. Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is a primary mechanical circulatory support (MCS) device for the treatment of PCS. Despite the long-standing and growing use of VA-ECMO in clinical practice, there are still many debated questions regarding its effectiveness in treating cardiogenic shock in elderly patients. The problem remains particularly important in the setting of the aging population. In this retrospective study, we evaluated the impact of VA-ECMO on clinical outcomes in elderly patients with PCS. A detailed analysis of patient history, demographics, laboratory and instrumental tests, pre- and perioperative parameters, complications, prognostic factors, and early and long-term outcomes was performed. We found that older age is an independent prognostic marker of mortality in patients receiving MCS. Female sex, doses of vasoactive drugs, and the duration before VA-ECMO implantation are also associated with an increased risk of in-hospital mortality. Although early and long-term outcomes in elderly patients undergoing VA-ECMO for PCS are worse than those in younger patients, they are acceptable. When candidates are appropriately selected, VA-ECMO can be an effective tool for the treatment of cardiogenic shock in elderly patients. |
