Outcome of extracorporeal membrane oxygenation support for complex high-risk elective percutaneous coronary interventions: A single-center experience

Objective: We report our initial experience with extracorporeal membrane oxygenation (ECMO) use in elective high-risk complex percutaneous coronary intervention (PCI). Background: ECMO has been employed as hemodynamic support in patients with cardiac arrest and hemodynamic shock. Methods: We performed a single-center prospectical study, enrolling all patients at very high-risk for coronary artery bypass grafting (CABG). Major adverse cardiac and cerebrovascular events (MACCE) were defined as a composite of death, acute myocardial infarction (MI), stroke and further need for revascularization. Results: Twelve patients underwent elective high-risk PCI with ECMO support (mean age=63.5±8.7 years). The mean SYNTAX score was 30.1±10.1. All PCI procedures were successful and no in-hospital MACCE was observed. At 6-months, neither death nor MI was noticed. Two patients (17%) required further revascularization, and one patient required chronic hemodialysis. Conclusions: Elective high-risk PCI supported by ECMO is a viable alternative for patients who are at very high risk for CABG.