Veno-arterial Extracorporeal Membrane Oxygenation as Bridge to Heart Transplantation: The Way Forward

Andrea Montisci, MD
Francesco Donatelli, MD
Silvia Cirri, MD
Enrico Coscioni, MD
Ciro Maiello, MD
Claudio Napoli, MD, PhD, MBE

Open link

Publication date

August 2021

DOI

10.1097/TXD.0000000000001172

Publisher

Ovid Technologies (Wolters Kluwer Health)

Journal

Transplantation Direct

Abstract

Advanced heart failure (HF) represents a public health priority due to the increase of affected patients and the meaningful mortality. Durable mechanical circulatory support (MCS) and heart transplantation (HTx) are unique therapies for end-stage HF (ESHF), with positive early and long-term outcomes. The patients who underwent HTx have a 1-y survival of 91% and a median survival of 12–13 y, whereas the median survival of ESHF is <12 mo. Short-term MCS with veno-arterial extracorporeal membrane oxygenation (VA ECMO) can be used as a bridge to transplantation strategy. Patients bridged with VA ECMO have significantly lower survival in comparison with non-MCS bridged and left ventricular assist device-bridged patients. VA ECMO represents an ef...