Post-pericardiectomy ECMO for constrictive pericarditis: a case series and literature review
Abstract 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,...
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BMC
2025-03-01
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| Series: | BMC Anesthesiology |
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| Online Access: | https://doi.org/10.1186/s12871-025-02977-4 |
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| author | 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 Bingyang Ji |
| author_facet | 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 Bingyang Ji |
| author_sort | Bin Jia |
| collection | DOAJ |
| description | Abstract 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. |
| format | Article |
| id | doaj-art-9fbde2e192fa4d65a753fdb6755205d6 |
| institution | DOAJ |
| issn | 1471-2253 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | BMC |
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| series | BMC Anesthesiology |
| spelling | doaj-art-9fbde2e192fa4d65a753fdb6755205d62025-08-20T03:18:41ZengBMCBMC Anesthesiology1471-22532025-03-0125111110.1186/s12871-025-02977-4Post-pericardiectomy ECMO for constrictive pericarditis: a case series and literature reviewBin Jia0Shujie Yan1Yong Luo2Jian Cheng3Jie Cheng4Junjie Fei5Yushuang Gao6Xiao Liao7Luyu Bian8Jian Wang9Yuan Teng10Gang Liu11Lanying Gao12Bingyang Ji13Department of Cardiovascular Surgery, The third People’s Hospital of ChengduDepartment of Cardiopulmonary Bypass, Fuwai Hospital, National Center for Cardiovascular DiseaseDepartment of Cardiovascular Surgery, The third People’s Hospital of ChengduDepartment of Cardiovascular Surgery, The third People’s Hospital of ChengduDepartment of Cardiovascular Surgery, The third People’s Hospital of ChengduDepartment of Cardiovascular Surgery, The third People’s Hospital of ChengduDepartment of Cardiovascular Surgery, The third People’s Hospital of ChengduDepartment of Cardiovascular Surgery, The third People’s Hospital of ChengduDepartment of Cardiopulmonary Bypass, Fuwai Hospital, National Center for Cardiovascular DiseaseDepartment of Cardiopulmonary Bypass, Fuwai Hospital, National Center for Cardiovascular DiseaseDepartment of Cardiopulmonary Bypass, Fuwai Hospital, National Center for Cardiovascular DiseaseDepartment of Cardiopulmonary Bypass, Fuwai Hospital, National Center for Cardiovascular DiseaseDepartment of Cardiovascular Surgery, The third People’s Hospital of ChengduDepartment of Cardiopulmonary Bypass, Fuwai Hospital, National Center for Cardiovascular DiseaseAbstract 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.https://doi.org/10.1186/s12871-025-02977-4Extracorporeal membrane oxygenation (ECMO)PericardiectomyConstrictive pericarditis |
| spellingShingle | 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 Bingyang Ji Post-pericardiectomy ECMO for constrictive pericarditis: a case series and literature review BMC Anesthesiology Extracorporeal membrane oxygenation (ECMO) Pericardiectomy Constrictive pericarditis |
| title | Post-pericardiectomy ECMO for constrictive pericarditis: a case series and literature review |
| title_full | Post-pericardiectomy ECMO for constrictive pericarditis: a case series and literature review |
| title_fullStr | Post-pericardiectomy ECMO for constrictive pericarditis: a case series and literature review |
| title_full_unstemmed | Post-pericardiectomy ECMO for constrictive pericarditis: a case series and literature review |
| title_short | Post-pericardiectomy ECMO for constrictive pericarditis: a case series and literature review |
| title_sort | post pericardiectomy ecmo for constrictive pericarditis a case series and literature review |
| topic | Extracorporeal membrane oxygenation (ECMO) Pericardiectomy Constrictive pericarditis |
| url | https://doi.org/10.1186/s12871-025-02977-4 |
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