@article{RadakovicPenovHamoudaetal.2022, author = {Radakovic, Dejan and Penov, Kiril and Hamouda, Khaled and Madrahimov, Nodir and Radakovic, Darko and Bening, Constanze and Leyh, Rainer G. and Aleksic, Ivan}, title = {Benefits of intra-aortic balloon pump support in patients with postcardiotomy shock requiring venoarterial extracorporeal membrane oxygenation}, series = {Life}, volume = {12}, journal = {Life}, number = {8}, issn = {2075-1729}, doi = {10.3390/life12081195}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-286241}, year = {2022}, abstract = {Background: The benefit of the combined use of an intra-aortic balloon pump (IABP) and venoarterial extracorporeal membrane oxygenation (VA-ECMO) for postcardiotomy shock remains unclear. We aimed to analyse the potential benefits and safety of combining these two devices. Methods: We enrolled 200 patients treated with either VA-ECMO only or in combination with IABP (ECMO-I group) between January 2012 and January 2021. To adjust the patients' backgrounds, we used propensity score matching for additional analyses, resulting in 57 pairs. The primary endpoint was 30-day survival. Secondary endpoints included successful weaning and complication rates. We also analysed hemodynamic parameters in both groups. Results: After propensity score matching, 30-day survival was better in the ECMO-I group (log-rank p = 0.004). The ECMO-I and ECMO-only groups differed regarding the secondary endpoints, including successful weaning (50.9\% and 26.3\%, respectively; p = 0.012) and the need for continuous renal replacement therapy (28.1\% and 50.9\%, p = 0.021). Complication rates were not statistically different between the two groups. Conclusion: Compared to VA-ECMO alone, the combined use of VA-ECMO and IABP is beneficial regarding 30-day survival in selected patients with postcardiotomy shock; successful ECMO weaning and freedom from renal replacement therapy is more common in patients supported with VA-ECMO plus IABP.}, language = {en} } @article{PenovRadakovicMadrahimovetal.2022, author = {Penov, Kiril and Radakovic, Dejan and Madrahimov, Nodir and Aleksic, Ivan}, title = {Subacute Aortic Rupture Due to Mechanical Chest Compression with Indwelling Impella}, series = {The Thoracic and Cardiovascular Surgeon Reports}, volume = {11}, journal = {The Thoracic and Cardiovascular Surgeon Reports}, number = {1}, issn = {2194-7635}, doi = {10.1055/s-0042-1757873}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-300174}, pages = {e64 -- e66}, year = {2022}, abstract = {Mechanical cardiopulmonary resuscitation (CPR) devices like Lund University Cardiopulmonary Assist System (LUCAS) cause more skeletal and visceral injuries than standard CPR. A 62-year-old woman with ST-elevation myocardial infarction was resuscitated with LUCAS and Impella CP for refractory cardiogenic shock during percutaneous coronary intervention. She suffered delayed ascending aortic rupture necessitating supracommissural ascending aortic replacement plus triple bypass grafting. Prolonged mechanical CPR with concomitant Impella may lead to aortic rupture. The combined use of LUCAS and Impella may have disastrous consequences.}, language = {en} }