Bin Jia, Shujie Yan, Yong Luo, Jian Cheng, Jie Cheng, Junjie Fei, Yushuang Gao, Xiao Liao, Luyu Bian, Jian Wang, Yuan Teng, Gang Liu, Lanying Gao, Binyang Ji
{"title":"心包切除术后ECMO治疗缩窄性心包炎：一个病例系列和文献回顾。","authors":"Bin Jia, Shujie Yan, Yong Luo, Jian Cheng, Jie Cheng, Junjie Fei, Yushuang Gao, Xiao Liao, Luyu Bian, Jian Wang, Yuan Teng, Gang Liu, Lanying Gao, Binyang Ji","doi":"10.1186/s12871-025-02977-4","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Pericardiectomy is the curative treatment for constrictive pericarditis, yet postoperative low cardiac output syndrome (LCOS) may occur. The application of venoarterial extracorporeal membrane oxygenation (VA-ECMO) in post-pericardiectomy refractory LCOS has limited case reports, and its effectiveness and safety remain unclear. This study aims to provide evidence for the effectiveness of ECMO in treating post-pericardiectomy refractory LCOS.</p><p><strong>Methods: </strong>Nine cases of post-pericardiectomy ECMO from two high-volume pericardiectomy centers in China were retrospectively reviewed. Meanwhile, a literature search was performed in PubMed and Embase on December 4, 2024. After screening, 5 articles were finally included for data extraction and comprehensive analysis.</p><p><strong>Results: </strong>Case Series: There were 4 cases of tuberculous etiology, 1 with a history of cardiac surgery, and 4 idiopathic cases. All patients were in New York Heart Association class III - IV at baseline. All the patients undertwent pericardiectomy via median sternotomy, and 5 patients underwent concomitant valve procedures. One patient failed to wean from the cardiopulmonary bypass (CPB) and was transferred to femoral VA-ECMO. Eight patients received femoral VA-ECMO support 4-96 h after surgery due to refractory LCOS. All the patients survived to discharge with good neurological outcomes after 120-192 h of ECMO support. Two patient were lost to follow-up, and the rest 7 patients survived to follow-up with a mean follow-up of 56 months.</p><p><strong>Literature review: </strong>4 case reports and 1 retrospective study were identified. In the retrospective study of 69 patients, 8 received ECMO during or after pericardiectomy with a hospital mortality rate of 63%. The four Patients of the 4 case reports were all survival at hospital discharge.</p><p><strong>Conclusions: </strong>VA-ECMO might be effective for refractory LCOS after pericardiectomy in patients with constrictive pericarditis, and could improve survival rates.</p>","PeriodicalId":9190,"journal":{"name":"BMC Anesthesiology","volume":"25 1","pages":"110"},"PeriodicalIF":2.3000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11871819/pdf/","citationCount":"0","resultStr":"{\"title\":\"Post-pericardiectomy ECMO for constrictive pericarditis: a case series and literature review.\",\"authors\":\"Bin Jia, Shujie Yan, Yong Luo, Jian Cheng, Jie Cheng, Junjie Fei, Yushuang Gao, Xiao Liao, Luyu Bian, Jian Wang, Yuan Teng, Gang Liu, Lanying Gao, Binyang Ji\",\"doi\":\"10.1186/s12871-025-02977-4\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Pericardiectomy is the curative treatment for constrictive pericarditis, yet postoperative low cardiac output syndrome (LCOS) may occur. The application of venoarterial extracorporeal membrane oxygenation (VA-ECMO) in post-pericardiectomy refractory LCOS has limited case reports, and its effectiveness and safety remain unclear. This study aims to provide evidence for the effectiveness of ECMO in treating post-pericardiectomy refractory LCOS.</p><p><strong>Methods: </strong>Nine cases of post-pericardiectomy ECMO from two high-volume pericardiectomy centers in China were retrospectively reviewed. Meanwhile, a literature search was performed in PubMed and Embase on December 4, 2024. After screening, 5 articles were finally included for data extraction and comprehensive analysis.</p><p><strong>Results: </strong>Case Series: There were 4 cases of tuberculous etiology, 1 with a history of cardiac surgery, and 4 idiopathic cases. All patients were in New York Heart Association class III - IV at baseline. All the patients undertwent pericardiectomy via median sternotomy, and 5 patients underwent concomitant valve procedures. One patient failed to wean from the cardiopulmonary bypass (CPB) and was transferred to femoral VA-ECMO. Eight patients received femoral VA-ECMO support 4-96 h after surgery due to refractory LCOS. All the patients survived to discharge with good neurological outcomes after 120-192 h of ECMO support. Two patient were lost to follow-up, and the rest 7 patients survived to follow-up with a mean follow-up of 56 months.</p><p><strong>Literature review: </strong>4 case reports and 1 retrospective study were identified. In the retrospective study of 69 patients, 8 received ECMO during or after pericardiectomy with a hospital mortality rate of 63%. The four Patients of the 4 case reports were all survival at hospital discharge.</p><p><strong>Conclusions: </strong>VA-ECMO might be effective for refractory LCOS after pericardiectomy in patients with constrictive pericarditis, and could improve survival rates.</p>\",\"PeriodicalId\":9190,\"journal\":{\"name\":\"BMC Anesthesiology\",\"volume\":\"25 1\",\"pages\":\"110\"},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2025-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11871819/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BMC Anesthesiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s12871-025-02977-4\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ANESTHESIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMC Anesthesiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12871-025-02977-4","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}
Post-pericardiectomy ECMO for constrictive pericarditis: a case series and literature review.
Background: Pericardiectomy is the curative treatment for constrictive pericarditis, yet postoperative low cardiac output syndrome (LCOS) may occur. The application of venoarterial extracorporeal membrane oxygenation (VA-ECMO) in post-pericardiectomy refractory LCOS has limited case reports, and its effectiveness and safety remain unclear. This study aims to provide evidence for the effectiveness of ECMO in treating post-pericardiectomy refractory LCOS.
Methods: Nine cases of post-pericardiectomy ECMO from two high-volume pericardiectomy centers in China were retrospectively reviewed. Meanwhile, a literature search was performed in PubMed and Embase on December 4, 2024. After screening, 5 articles were finally included for data extraction and comprehensive analysis.
Results: Case Series: There were 4 cases of tuberculous etiology, 1 with a history of cardiac surgery, and 4 idiopathic cases. All patients were in New York Heart Association class III - IV at baseline. All the patients undertwent pericardiectomy via median sternotomy, and 5 patients underwent concomitant valve procedures. One patient failed to wean from the cardiopulmonary bypass (CPB) and was transferred to femoral VA-ECMO. Eight patients received femoral VA-ECMO support 4-96 h after surgery due to refractory LCOS. All the patients survived to discharge with good neurological outcomes after 120-192 h of ECMO support. Two patient were lost to follow-up, and the rest 7 patients survived to follow-up with a mean follow-up of 56 months.
Literature review: 4 case reports and 1 retrospective study were identified. In the retrospective study of 69 patients, 8 received ECMO during or after pericardiectomy with a hospital mortality rate of 63%. The four Patients of the 4 case reports were all survival at hospital discharge.
Conclusions: VA-ECMO might be effective for refractory LCOS after pericardiectomy in patients with constrictive pericarditis, and could improve survival rates.
期刊介绍：
BMC Anesthesiology is an open access, peer-reviewed journal that considers articles on all aspects of anesthesiology, critical care, perioperative care and pain management, including clinical and experimental research into anesthetic mechanisms, administration and efficacy, technology and monitoring, and associated economic issues.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
