{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T17:31:00Z","timestamp":1776706260259,"version":"3.51.2"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,4,17]],"date-time":"2023-04-17T00:00:00Z","timestamp":1681689600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Percutaneous extracorporeal life support (pECLS) is increasingly applied in cardiogenic shock (CS) despite a lack of evidence from randomized trials. The in-hospital mortality rate of pECLS still reaches up to 60%, while vascular access site complications remain a shortcoming. Surgical approaches with central cannulation for ECLS (cELCS) have emerged as a bail-out option. To date, no systematic approach exists that allows a definition of inclusion or exclusion criteria for cECLS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>This single-center, retrospective, case-control study includes all patients fulfilling criteria for CS at the West German Heart and Vascular Center Essen\/Germany between 2015 and 2020 who underwent cECLS (<jats:italic>n<\/jats:italic>\u2009=\u200958), excluding post-cardiotomy patients. Seventeen patients received cECLS (29.3%) as a first-line treatment strategy and 41 patients as a second-line strategy (70.7%). The main complications leading to the use of cECLS as a second-line strategy were limb ischemia (32.8%) and ongoing insufficient hemodynamic support (27.6%). The first-line cECLS cohort showed a 30-day mortality rate of 53.3% that was constant during follow-up. The 30-day mortality rate of secondary cECLS candidates was 69.8% and the rate at 3 and 6 months was 79.1%. Younger patients (&amp;lt;55 years) were more likely to exhibit survival benefit with cECLS (<jats:italic>p<\/jats:italic>\u2009=\u20090.043).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Surgical cECLS in CS is a feasible therapy for highly selected patients with hemodynamic instability, vascular complications, or peripheral access site limitations as complementary strategy in experienced centers.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2023.1142953","type":"journal-article","created":{"date-parts":[[2023,4,17]],"date-time":"2023-04-17T05:54:02Z","timestamp":1681710842000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Central extracorporeal circulatory life support (cECLS) in selected patients with critical cardiogenic shock"],"prefix":"10.3389","volume":"10","author":[{"given":"Leonie","family":"Schmack","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bastian","family":"Schmack","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Papathanasiou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fadi","family":"Al-Rashid","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Weymann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikolaus","family":"Pizanis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Markus","family":"Kamler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arjang","family":"Ruhparwar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tienush","family":"Rassaf","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Luedike","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,4,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1315","DOI":"10.1002\/ejhf.1922","article-title":"Epidemiology, pathophysiology and contemporary management of cardiogenic shock\u2014a position statement from the Heart Failure Association of the European Society of Cardiology","volume":"22","author":"Chioncel","year":"2020","journal-title":"Eur J Heart Fail"},{"key":"B2","doi-asserted-by":"publisher","first-page":"e274","DOI":"10.4244\/EIJY21M05_01","article-title":"Joint EAPCI\/ACVC expert consensus document on percutaneous ventricular assist devices","volume":"17","author":"Chieffo","year":"2021","journal-title":"EuroIntervention"},{"key":"B3","doi-asserted-by":"publisher","first-page":"2298","DOI":"10.1161\/CIRCULATIONAHA.118.036691","article-title":"Venoarterial extracorporeal membrane oxygenation for cardiopulmonary support","volume":"138","author":"Becher","year":"2018","journal-title":"Circulation"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1404","DOI":"10.1097\/CCM.0b013e31816f7cf7","article-title":"Outcomes and long-term quality-of-life of patients supported by extracorporeal membrane oxygenation for refractory cardiogenic shock","volume":"36","author":"Combes","year":"2008","journal-title":"Crit Care Med"},{"key":"B5","doi-asserted-by":"publisher","first-page":"454","DOI":"10.1161\/CIRCULATIONAHA.122.062949","article-title":"ECMO-CS Investigators. 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