Outcome in patients with cardiogenic shock supported by preoperative extracorporeal membrane oxygenation (ECMO)

Background: We summarise the surgical outcomes in patients with cardiogenic shock, supported by preoperative extracorporeal membrane oxygenation (ECMO) before cardiac and non-cardiac surgery. Methods: Our study was conducted as a retrospective analysis in the Department of Cardiothoracic Surgery in a large university-affiliated hospital. All data were extracted from our departmental database. During 7-year, between 01.01.2018 and 31.12.2024, we studied 97 patients with cardiogenic shock, preoperatively supported by ECMO, who underwent urgent/emergent cardiac or non-cardiac surgery. Results: 57 patients of them underwent LVAD implantation, two BiVAD implantation and one heart transplantation. 27 patients underwent different kind of valve surgery due acute mitral/aortic regurgitation or stuck valve. Eight patients had acute VSD repai and two was underwent non-cardiac surgery e.g. pheochromocytoma excision. 75 patients (77%) were successfully weaned off from ECMO after their surgeries. Preoperative ECMO time ranged from 243 h to 16 h, with a median of 69.5h and postoperative ECMO time ranged from 123 to 13. h, with a median of 34.6 h. 43 patients (44.3%) died postoperatively. The follow up time for the ranged from 107.5 to 0.8 month. Conclusion: ECMO is a vital bridge in the preparation of critically-ill patients for cardiac surgery. It is associated with acceptable outcomes among most of the patients.