CSA Home
Central Surgical Association

Back to 2022 Abstracts


Percutaneous Concomitant Right And Left Ventricular Support Reduces Limb Ischemia Compared To Peripheral Venoarterial Extra Corporeal Membrane Oxygenation.
*Richard W Walsh, *Nathan J Smith, *Mia S Turbati, *David L Joyce, Peter W Rossi
Medical College of Wisconsin, Milwaukee, WI

OBJECTIVE(S): Mechanical Circulatory Support (MCS) is a mainstay in the treatment of adult cardiogenic shock and may be associated with the risk of limb ischemia. We compared the risk of limb ischemia between the peripheral method of MCS to an approach utilizing percutaneous biventricular support.
METHODS: This was a retrospective cohort study of patients placed on MCS for cardiogenic shock, or for cardiac protection, between January 1, 2015-December 5, 2021 at our institution. Incidence of limb ischemia between a novel MCS strategy with percutaneous right and left ventricular assist devices compared to femoral VA ECMO was evaluated. Baseline demographics and hemodynamic data were collected. A Fischerís Exact test comparison evaluated the incidence of limb ischemia.
RESULTS: 49 patients underwent the studied MCS modalities at our institution with 12 patients in the novel MCS group and 37 in the peripheral VA ECMO group. Baseline characteristics including patient end-organ function, etiology of heart failure, and BMI/ BSA were similar among the groups. The novel approach group was exclusively male. Fischerís Exact testing demonstrated a lower rate of limb ischemia with the novel approach compared to traditional peripheral therapy (p < 0.001).
CONCLUSIONS: Peripheral VA ECMO confers a higher risk of limb ischemia compared to the novel approach of percutaneous biventricular support. This novel method has a lower risk of limb ischemia.


Back to 2022 Abstracts