TY - JOUR
T1 - Extracorporeal Life Support for Post-Cardiotomy Acute Right Ventricular Failure
T2 - a Retrospective Observational Multicenter Study
AU - PELS-1 Investigators
AU - Bianchi, Giacomo
AU - Perazzo, Alvaro
AU - Mariani, Silvia
AU - van Bussel, Bas C T
AU - Di Mauro, Michele
AU - Wiedeman, Dominik
AU - Saeed, Diyar
AU - Pozzi, Matteo
AU - Botta, Luca
AU - Boeken, Udo
AU - Samalavicius, Robertas
AU - Bounader, Karl
AU - Hou, Xiaotong
AU - Bunge, Jeroen J H
AU - Buscher, Hergen
AU - Salazar, Leonardo
AU - Meyns, Bart
AU - Mazzeffi, Michael A
AU - Matteucci, Sacha
AU - Sponga, Sandro
AU - Ramanathan, Kollengode
AU - Russo, Claudio Francesco
AU - Formica, Francesco
AU - Sakiyalak, Pranya
AU - Fiore, Antonio
AU - Camboni, Daniele
AU - Raffa, Giuseppe Maria
AU - Diaz, Rodrigo
AU - Wang, I-Wen
AU - Jung, Jae-Seung
AU - Belohlavek, Jan
AU - Pellegrino, Vin
AU - Pettinari, Matteo
AU - Barbone, Alessandro
AU - Gaiotto, Fabio Antonio
AU - Garcia, José P
AU - Shekar, Kiran
AU - Whitman, Glenn
AU - Solinas, Marco
AU - Lorusso, Roberto
AU - Heuts, Samuel
AU - Schaefer, Anne-Kristin
AU - Conci, Luca
AU - Khalil, Jawad
AU - Lehmann, Sven
AU - Obadia, Jean-Francois
AU - Loforte, Antonio
AU - Pacini, Davide
AU - Kalampokas, Nikolaos
AU - Jankuviene, Agne
N1 - Copyright © 2026 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
PY - 2026/3/13
Y1 - 2026/3/13
N2 - BACKGROUND: Post-cardiotomy acute right ventricular failure (aRVF) constitutes a complex clinical challenge that might necessitate escalating interventions, including extracorporeal life support (ECLS). This study evaluates outcomes of adults requiring ECLS for post-cardiotomy acute right ventricular failure (aRVF) compared to other post-cardiotomy indications.METHODS: In this multicenter, international, retrospective study, we analyzed patients undergoing post-cardiotomy ECLS from January 2000 to December 2020 and compared patients' characteristics and in-hospital mortality between aRVF and other indications groups.RESULTS: Of 2010 patients, 240 (12%) had aRVF and 1770 (88%) had other indication for ECLS. Demographics were similar between groups (median age: 65 years [55-72]; p=0.217; males 60%; p=0.675). The aRVF group showed higher pre-operative right-sided cardiac dysfunction, including pre-existing right ventricular failure (aRVF: 22%; other indications: 8%; p<0.001) and biventricular failure (aRVF: 12%; other indications: 7%; p=0.013). aRVF patients more frequently underwent tricuspid valve surgery (aRVF: 20%; other indications: 13%; p=0.003) and aortic root procedures (aRVF: 24%; other indications: 13%). They also required longer ECLS support (aRVF: 135 hours [70-221]; other indications:116 hours [58-192]; p=0.025) and longer intensive care unit stay (aRVF: 15 days [7-291]; other indications: 13 days [6-25]; p=0.042). Despite more complications, including non-surgical bleeding (aRVF: 31%; other indications: 25%; p=0.042) and persistent right heart failure (aRVF: 50%; other indications: 17%; p<0.001), both in-hospital survival (aRVF: 59%; other indications: 61%; p=0.526) and long-term survival were comparable (log-rank p=0.17).CONCLUSIONS: Patients requiring ECLS for post-cardiotomy aRVF, despite higher pre-operative risks and complex clinical courses, achieve survival rates comparable to other indications patients.
AB - BACKGROUND: Post-cardiotomy acute right ventricular failure (aRVF) constitutes a complex clinical challenge that might necessitate escalating interventions, including extracorporeal life support (ECLS). This study evaluates outcomes of adults requiring ECLS for post-cardiotomy acute right ventricular failure (aRVF) compared to other post-cardiotomy indications.METHODS: In this multicenter, international, retrospective study, we analyzed patients undergoing post-cardiotomy ECLS from January 2000 to December 2020 and compared patients' characteristics and in-hospital mortality between aRVF and other indications groups.RESULTS: Of 2010 patients, 240 (12%) had aRVF and 1770 (88%) had other indication for ECLS. Demographics were similar between groups (median age: 65 years [55-72]; p=0.217; males 60%; p=0.675). The aRVF group showed higher pre-operative right-sided cardiac dysfunction, including pre-existing right ventricular failure (aRVF: 22%; other indications: 8%; p<0.001) and biventricular failure (aRVF: 12%; other indications: 7%; p=0.013). aRVF patients more frequently underwent tricuspid valve surgery (aRVF: 20%; other indications: 13%; p=0.003) and aortic root procedures (aRVF: 24%; other indications: 13%). They also required longer ECLS support (aRVF: 135 hours [70-221]; other indications:116 hours [58-192]; p=0.025) and longer intensive care unit stay (aRVF: 15 days [7-291]; other indications: 13 days [6-25]; p=0.042). Despite more complications, including non-surgical bleeding (aRVF: 31%; other indications: 25%; p=0.042) and persistent right heart failure (aRVF: 50%; other indications: 17%; p<0.001), both in-hospital survival (aRVF: 59%; other indications: 61%; p=0.526) and long-term survival were comparable (log-rank p=0.17).CONCLUSIONS: Patients requiring ECLS for post-cardiotomy aRVF, despite higher pre-operative risks and complex clinical courses, achieve survival rates comparable to other indications patients.
U2 - 10.1016/j.athoracsur.2026.02.033
DO - 10.1016/j.athoracsur.2026.02.033
M3 - Journal article
C2 - 41833792
SN - 0003-4975
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
ER -