@article{10902/36185,
year = {2019},
url = {https://hdl.handle.net/10902/36185},
abstract = {Objectives: To investigate the potential clinical benefit of an intra-aortic balloon pump (IABP) in patients supported with venoarterial extracorporeal membrane oxygenation (VA-ECMO) as a bridge to heart transplantation (HT).
Methods: We studied 169 patients who were listed for urgent HT under VA-ECMO support at 16 Spanish institutions from 2010 to 2015. The clinical outcomes of patients under simultaneous IABP support (n=73) were compared to a control group of patients without IABP support (n=96).
Results: There were no statistically significant differences between the IABP and control groups with regard to the cumulative rates of transplantation (71.2% vs 81.2%, P=0.17), death during VA-ECMO support (20.6% vs 14.6%, P=0.31), transition to a different mechanical circulatory support device (5.5% vs 5.2%, P=0.94) or weaning from VA-ECMO support due to recovery (2.7% vs 0%, P=0.10). There was a higher incidence of bleeding events in the IABP group (45.2% vs 25%, P=0.006; adjusted odds ratio 2.18, 95% confidence interval 1.02-4.67). In-hospital postoperative mortality after HT was 34.6% in the IABP group and 32.5% in the control group (P=0.80). One-year survival after listing for urgent HT was 53.3% in the IABP group and 52.2% in the control group (log rank P=0.75). Multivariate adjustment for potential confounders did not change this result (adjusted hazard ratio 0.94, 95% confidence interval 0.56-1.58).
Conclusions: In our study, simultaneous IABP therapy in transplant candidates under VA-ECMO support did not significantly reduce morbidity or mortality.},
organization = {Funding: This study was funded by a research grant from the Fundación Mutua Madrileña, Madrid, Spain. A few investigators of this study are affiliated with the Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV) of the Instituto de Salud Carlos III. Acknowledgements: The authors are grateful to the staff of the Organizacio´ n Nacional de Trasplantes (ONT) for their collaboration in this study.},
publisher = {Oxford University Press},
publisher = {Interactive Cardiovascular and Thoracic Surgery, 2019, 29(5), 670-677},
title = {Venoarterial extracorporeal membrane oxygenation with or without simultaneous intra-aortic balloon pump support as a direct bridge to heart transplantation: results from a nationwide Spanish registry},
author = {Barge-Caballero, Gonzalo and Castel-Lavilla, María A. and Almenar-Bonet, Luis and Garrido-Bravo, Iris P. and Delgado, Juan F. and Rangel-Sousa, Diego and González-Costello, José and Segovia-Cubero, Javier and Farrero-Torres, Marta and Lambert-Rodríguez, José Luis and Crespo-Leiro, María G. and Hervás-Sotomayor, Daniela and Portolés-Ocampo, Ana and Martínez-Sellés, Manuel and De la Fuente-Galán, Luis and Rábago-Juan-Aracil, Gregorio and González Vílchez, Francisco Jesús and Mirabet-Pérez, Sonia and Muñiz, Javier and Barge-Caballero, Eduardo},
}