{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:04:28Z","timestamp":1792785868048,"version":"4.5.0"},"reference-count":14,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2024,12,30]],"date-time":"2024-12-30T00:00:00Z","timestamp":1735516800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Berta-Ottenstein-Programme for Advanced Clinician Scientists, Faculty of Medicine"},{"DOI":"10.13039\/501100002714","name":"University of Freiburg","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002714","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,2,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>OBJECTIVES<\/jats:title>\n                    <jats:p>The study\u2019s aim was to investigate the outcomes and risk factors for mortality in patients undergoing surgery for acute type A aortic dissection receiving concomitant venoarterial extracorporeal membrane oxygenation (ECMO) support.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Patients from 5 European centre who underwent surgery for acute type A aortic dissection and received perioperative venoarterial ECMO support were included. A multivariable binary logistic regression analysis was performed to identify risk factors for 30-day mortality. A receiver operating characteristic curve and restricted cubic splines were designed to investigate the association between pre-ECMO lactate peak and survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>The final cohort comprised 117 patients. Mean time on ECMO support was 3\u2009days (interquartile range 1\u20137). In 36 patients (31%), successful ECMO weaning was achieved. Thirty-day mortality was 72%, leading cause for early mortality was multiorgan failure (39%). In total, 20% of patients were discharged from hospital. Pre-ECMO lactate peak [odds ratio (OR) 1.02, 95% confidence interval (CI) 1.005\u20131.032], presence of preoperative shock (OR 9.47, 95% CI 1.749\u201398.257) and need for total arch replacement (OR 6.628, 95% CI 1.492\u201333.373) were identified as associates for 30-day mortality. For pre-ECMO lactate peak, the area under the curve showed an acceptable value of 0.73 and restricted cubic splines showed a significant correlation to survival (P\u2009=\u20090.004) with an increased risk above a lactate level of 85\u2009mg\/dl.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Venoarterial ECMO support may not be futile but should be well balanced against the high-risk profile in this patient cohort. The pre-ECMO lactate peak is an independent risk factor and a valid predictor of 30-day mortality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejcts\/ezae467","type":"journal-article","created":{"date-parts":[[2024,12,29]],"date-time":"2024-12-29T15:19:27Z","timestamp":1735485567000},"source":"Crossref","is-referenced-by-count":6,"title":["Predictors and outcomes in patients undergoing surgery for acute type A aortic dissection requiring concomitant venoarterial extracorporeal membrane oxygenation support\u2014a retrospective multicentre cohort study"],"prefix":"10.1093","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-0339-5791","authenticated-orcid":false,"given":"Leonard","family":"Pitts","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charit\u00e9 (DHZC) , Berlin,","place":["Germany"]},{"name":"Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin , Berlin,","place":["Germany"]},{"name":"DZHK (German Centre for Cardiovascular Research), Partner Site Berlin , Berlin,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0180-8338","authenticated-orcid":false,"given":"Simone","family":"Gasser","sequence":"additional","affiliation":[{"name":"University Clinic for Cardiac Surgery, Medical University Innsbruck , Innsbruck,","place":["Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Murat","family":"Uzdenov","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Heart Centre Freiburg University, Faculty of Medicine, Albert Ludwig\u2019s University of Freiburg , Freiburg,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7232-3330","authenticated-orcid":false,"given":"Christopher","family":"Gaisendrees","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Heart Centre, University of Cologne , Cologne,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maris","family":"Bartkevics","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Inselspital Bern, University Hospital Bern , Bern,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3099-7254","authenticated-orcid":false,"given":"Maximilian","family":"Kreibich","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Heart Centre Freiburg University, Faculty of Medicine, Albert Ludwig\u2019s University of Freiburg , Freiburg,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maximilian","family":"Luehr","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Heart Centre, University of Cologne , Cologne,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2009-6375","authenticated-orcid":false,"given":"J\u00f6rg","family":"Kempfert","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charit\u00e9 (DHZC) , Berlin,","place":["Germany"]},{"name":"Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin , Berlin,","place":["Germany"]},{"name":"DZHK (German Centre for Cardiovascular Research), Partner Site Berlin , Berlin,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Schoenhoff","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Inselspital Bern, University Hospital Bern , Bern,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7911-8620","authenticated-orcid":false,"given":"Volkmar","family":"Falk","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charit\u00e9 (DHZC) , Berlin,","place":["Germany"]},{"name":"Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin , Berlin,","place":["Germany"]},{"name":"DZHK (German Centre for Cardiovascular Research), Partner Site Berlin , Berlin,","place":["Germany"]},{"name":"Translational Cardiovascular Technologies, Department of Health Sciences 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