%0 Journal Article
%A Barge-Caballero, Gonzalo
%A Castel-Lavilla, María A
%A Almenar-Bonet, Luis
%A Garrido-Bravo, Iris P
%A Delgado, Juan F
%A Rangel-Sousa, Diego
%A González-Costello, José
%A Segovia-Cubero, Javier
%A Farrero-Torres, Marta
%A Lambert-Rodríguez, José Luis
%A Crespo-Leiro, María G
%A Hervás-Sotomayor, Daniela
%A Portolés-Ocampo, Ana
%A Martínez-Sellés, Manuel
%A De la Fuente-Galán, Luis
%A Rábago-Juan-Aracil, Gregorio
%A González-Vílchez, Francisco
%A Mirabet-Pérez, Sonia
%A Muñiz, Javier
%A Barge-Caballero, Eduardo
%T 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.
%D 2019
%U http://hdl.handle.net/10668/14200
%X 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). 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). 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). In our study, simultaneous IABP therapy in transplant candidates under VA-ECMO support did not significantly reduce morbidity or mortality.
%K Extracorporeal membrane oxygenation
%K Heart transplantation
%K Intra-aortic balloon pump
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