272. Fifteen Years Experience of Direct Bridge with Veno-Arterial Extra-Corporeal Membrane Oxygenation to Heart Transplantation
Weill Cornell Medical College
Brooklyn, NY
United States - Contact Me
Dr. Berhane Worku is an Attending Cardiothoracic Surgeon and an Associate Professor of Cardiothoracic Surgery in the Department of Cardiothoracic Surgery at New York Presbyterian-Weill Cornell Medical Center and at Brooklyn Methodist Hospital. Dr. Worku completed his undergraduate studies at Brown University in 1998, obtaining a degree in neuroscience. He pursued his medical education at Harvard Medical School and completed his residency in general surgery at New York University Medical Center. He completed a research fellowship in cardiothoracic surgery at Columbia University Medical Center in 2010 and a clinical fellowship in cardiothoracic surgery at Weill Cornell Medical Center in 2012 and assumed his present position afterwards.
Dr. Worku has undertaken several research endeavors in the field of cardiothoracic surgery and has published extensively in several peer-reviewed journals. He is board certified by the American Board of Thoracic Surgery and the American Board of Surgery and is a member of several surgical societies, including the Society of Thoracic Surgery, the American College of Surgeons, the American Heart Association, the American College of Cardiology, and the American Association of Thoracic Surgeons.
Dr. Worku’s practice focuses on adult cardiac surgery, including coronary artery bypass grafting, aortic, mitral, and tricuspid surgery, aortic aneurysm repair, and ablation for atrial fibrillation. In addition, Dr. Worku has additional interests in transcatheter therapies for aortic and mitral valve disease and surgical treatment of the failing heart, including percutaneous and permanent ventricular assist devices.
pitie-salpetrier hospital
Créteil
France - Contact Me
Last name: LAALI
First name: Mojgan
21 March 1967
Cardiovascular surgeon M.D Ph.D
At Sorbonne university , Pitié-Salpetrier Hospital, Paris, France
Member of Frenche college of Thoracic and Cardiovascular surgery
Member and proessor in French school of Multi organ Harvesting ( EFPMO)
Member of Paris ECMO program
Member of Frenche TAVI program (France II), (France TAVI)
Young researcher prize from the French society of Thoracic and Cardiovascular surgery for the idea of using magnetic force to correct the coaptation of aortic and mitral valves
Description
Methods: A single center retrospective study was realized on 1152 adult patients undergoing isolated cardiac transplantation between January 2007 and December 2021. Among these, patients bridged with a VA ECMO to transplantation (group ECMO, n=317) were compared to the other transplanted patients (group NoECMO, n=835). A period analysis (Era I 2007-13, n=97 vs Era II 2014-21, n=220) was performed for patients of group ECMO.
Results: Median duration of VA ECMO support before transplantation in the group ECMO was 8 days [4.00; 13.0]. Recipients of group ECMO were younger, with a better renal function, and a shorter time on waiting list before donor allocation. They were allocated to younger donors, with a longer ischemic time. Group ECMO and NoECMO showed similar 1-year mortality and 5-years survival: 21.07% vs. 21.13%, p=0.98, and 66.9% (95% CI 63.8%; 70.3%) vs. 67.8% (95% CI 62.8%; 73.3%, p=0.76). Period analysis of group ECMO showed improved 1-year mortality and 5-years survival in ERA II compared to ERA I: 18% vs. 29%, p=0.025 and 70.7% (95% CI 64.7%; 77.3%) vs. 60.8% (95% CI 51.8%; 71.4%, p=0.043). Better outcomes in ERA II were explained by the higher number of patients in whom ECMO support was systematically pursued after the transplantation (92% vs. 48%, p<0.001), mainly by a peripheral cannulation (99.51% vs. 57%, p<0.001).
Conclusions: VA ECMO as a direct bridge for heart transplantation shows similar outcomes than other transplanted patients, provided that time on waiting list could be short and systematic VA ECMO temporary support, with a peripheral approach, could be pursued after transplantation.
Authors
mojgan laali (1), guillaume coutance (2), Shaida Varnous (3), guillaume hekimian (4), cosimo d'alessandro (4), pierre demondion (5), guillaume lebreton (5), pascal leprince (5)
Institutions
(1) Pitie-Salpetrier Hospital, 0, France, (2) La Pitié - Salpêtrière, paris, france, (3) La Pitié - Salpêtrière, Paris, france, (4) La Pitié - Salpêtrière, Paris, France, (5) La Pitié - Salpêtrière Hospital, paris, NA