Objectives: Our objective was to examine the results of ECMO post cardiotomy in Centro Hospitalar Universitário S. João (CHUSJ). Methods: Between 2011 and 2019, 13 patients were cannulated for refractory cardiogenic shock post-cardiotomy; 8 (61,5%) male and 5 (38,5%) female. Patients under 18 years old were excluded. Data was collected from hospital archives concerning preoperative comorbidities, open-heart surgery procedure, dates of ECMO cannulation and decannulation, postoperative complications, hospital mortality and cause of death. Follow-up was obtained by review of the last outpatient observation. The outcomes investigated were hospital mortality and survival at 12, 36 and 60 months. Results: After a median ECMO-VA therapy of 6 days (1-16 days), 7 (53,8%) patients were successfully decannulated; from these 2 succumbed from stroke and septic shock, one is still in intermediate care convalescing steadily and 4 were discharged. Overall 8 (61,5%) patients died. 5 (38,5%) survived, 4 were discharged home and 1 is still in intermediate care. Survival (after discharge) at 12, 36 and 60 months was respectively 25%, 16,7% and 8,3%. Regarding postoperative complications, reoperation for bleeding was necessary in 5 (38.5%), stroke was diagnosed in 2 (15,4%), dialysis in 6 (46,2%), leg ischemia affected 5 (38,5%) and mediastinitis occurred in 1 (7,7%). Conclusions: VA ECMO saves a life in each three patients suffering from refractory cardiogenic shock after cardiac surgery. Despite risks associated with advanced cardiopulmonary support, survivors maintain good health condition.

Objectives: We aim to report our experience on venoarterial extracorporeal membrane oxygenation (VA-ECMO) for postcardiotomy shock (PCS). Methods: Single center, retrospective study of all patients on VA-ECMO for PCS, from November 2006 to July 2019. Pediatric and adult patients were analysed separately. Primary outcomes were survival to discharge and one-year survival. Results: Twenty-nine patients were included. Pediatric group (group PED) (62%, n=18): mean age 1,3±2,1 years and 39% male. Adults (group AD) (38%, n=11): mean age 55,6±15,9 years and 64% male. Indications in group PED were complex congenital heart surgery (94%) and heart transplant (6%), with 27% being reoperations; in group AD valvular surgery (45%), aortic surgery (21%), coronary artery bypass grafting (18%) and pulmonary endarterectomy (9%); 45% were reoperations. ECMO support was initiated intraoperatively due to failure to wean from cardiopulmonary bypass in 28% of group PED and 73% of group AD. Central cannulation was performed in all pediatric patients and 82% adults. Bleeding was the most common complication in both groups (group PED 39%, group AD 45%). Mean ECMO support time was respectively 6,2±4,9 and 6,2± 3,6 days for group PED and group AD. Weaning rate was 44% in group PED (with 2 patients bridged to LVAD) and 45% in group AD. Survival to discharge as well as one-year survival were both 28% in group PED and 18% in group AD. Conclusion: Despite low survival and high complication rates, VA ECMO support provides a survival benefit in refractory cases, with a dismal prognosis, that would otherwise die.