{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T06:13:37Z","timestamp":1783577617381,"version":"3.55.0"},"reference-count":36,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2022,11,13]],"date-time":"2022-11-13T00:00:00Z","timestamp":1668297600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>The outcomes of patients with PCS and following ECMO therapy are associated with several preoperative risk factors. Our aim was to compare clinical presentation, ECMO-related data and in-hospital outcomes of patients treated with ECMO due to PCS after cardiac surgery, in regard to elective or emergent cardiac surgery procedures. Between April 2006 and October 2016, 164 consecutive patients that received VA-ECMO therapy due to PCS were identified and included in this retrospective cohort study. The patients were divided into groups based on the urgency of the initial procedures performed: elective group (ELG; n = 95) and an emergency group (EMG; n = 69). To compare the unequal patient groups, a propensity score-based matching (PSM) was applied (ELG, n = 56 vs. EMG, n = 56). The EMG primarily received ECMO intraoperatively (p \u2264 0.001). In contrast, the ELG were needed ECMO support more frequently postoperatively (p &lt; 0.001). In-hospital mortality accounted for 71% (n = 40) in the ELG and 76% (n = 43) in the EMG (p = 0.518). Outcome data showed no major differences in the (abdominal ischemia (p = 0.371); septic shock (p = 0.393): rhythm disturbances (p = 0.575); emergency re-thoracotomy (p = 0.418)) between the groups. The urgency of the initial procedures performed is secondary in patients suffering PCS and following ECMO. In this regard, PCS itself seems to trigger outcomes in cardiac surgery ECMO patients substantially.<\/jats:p>","DOI":"10.3390\/life12111872","type":"journal-article","created":{"date-parts":[[2022,11,14]],"date-time":"2022-11-14T02:33:10Z","timestamp":1668393190000},"page":"1872","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Impact of Initial Operative Urgency on Short-Term Outcomes in Patients Treated with ECMO Due to Postcardiotomy Cardiogenic Shock"],"prefix":"10.3390","volume":"12","author":[{"given":"Borko","family":"Ivanov","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic Surgery, Heart Centre, Helios Hospital Siegburg, 53721 Siegburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0573-8218","authenticated-orcid":false,"given":"Ihor","family":"Krasivskyi","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Heart Centre, University Hospital Cologne, 50937 Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Gerfer","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Heart Centre, University Hospital Cologne, 50937 Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anton","family":"Sabashnikov","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Heart Centre, University Hospital Cologne, 50937 Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirko","family":"Doss","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Heart Centre, Helios Hospital Siegburg, 53721 Siegburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0613-4419","authenticated-orcid":false,"given":"David","family":"Holzhey","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Helios University Hospital Wuppertal, University Witten\/Herdecke, 42117 Wuppertal, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaveh","family":"Eghbalzadeh","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Heart Centre, University Hospital Cologne, 50937 Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2178-8397","authenticated-orcid":false,"given":"Christian","family":"Rustenbach","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, University Hospital Tuebingen, 72076 Tuebingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elmar","family":"Kuhn","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Heart Centre, University Hospital Cologne, 50937 Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parwis Baradaran","family":"Rahmanian","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Heart Centre, University Hospital Cologne, 50937 Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Navid","family":"Mader","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Heart Centre, University Hospital Cologne, 50937 Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5810-8626","authenticated-orcid":false,"given":"Ilija","family":"Djordjevic","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Heart Centre, University Hospital Cologne, 50937 Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thorsten","family":"Wahlers","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Heart Centre, University Hospital Cologne, 50937 Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2174","DOI":"10.1056\/NEJMoa040316","article-title":"Long-term outcomes of coronary-artery bypass grafting versus stent implantation","volume":"352","author":"Hannan","year":"2005","journal-title":"N. Engl. J. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1097\/MAT.0000000000001510","article-title":"ELSO Interim Guidelines for Venoarterial Extracorporeal Membrane Oxygenation in Adult Cardiac Patients","volume":"67","author":"Lorusso","year":"2021","journal-title":"ASAIO J."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s11936-015-0423-9","article-title":"Coronary Revascularization in Cardiogenic Shock","volume":"18","author":"Spence","year":"2016","journal-title":"Curr. Treat. Options Cardiovasc. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2032","DOI":"10.1016\/S0022-5223(03)00950-4","article-title":"Gender and outcomes after coronary artery bypass grafting: A propensity-matched comparison","volume":"126","author":"Koch","year":"2003","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1093\/icvts\/ivz268","article-title":"Life expectancy of patients undergoing surgical aortic valve replacement compared with that of the general population","volume":"30","author":"Diaz","year":"2020","journal-title":"Interact. Cardiovasc. Thorac Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e006370","DOI":"10.1161\/JAHA.117.006370","article-title":"Sex Differences in the Utilization and Outcomes of Surgical Aortic Valve Replacement for Severe Aortic Stenosis","volume":"6","author":"Chaker","year":"2017","journal-title":"J. Am. Heart Assoc."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1128","DOI":"10.1056\/NEJMsa012337","article-title":"Hospital volume and surgical mortality in the United States","volume":"346","author":"Birkmeyer","year":"2002","journal-title":"N. Engl. J. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1454","DOI":"10.1056\/NEJMsa042325","article-title":"Cardiac revascularization in specialty and general hospitals","volume":"352","author":"Cram","year":"2005","journal-title":"N. Engl. J. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1207","DOI":"10.1016\/j.jtcvs.2019.10.078","article-title":"Peripheral versus central extracorporeal membrane oxygenation for postcardiotomy shock: Multicenter registry, systematic review, and meta-analysis","volume":"160","author":"Mariscalco","year":"2020","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1385","DOI":"10.1253\/circj.CJ-11-1015","article-title":"Outcome of patients with profound cardiogenic shock after cardiopulmonary resuscitation and prompt extracorporeal membrane oxygenation support. A single-center observational study","volume":"76","author":"Chung","year":"2012","journal-title":"Circ. J."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1016\/S0003-4975(03)01329-8","article-title":"Five-year results of 219 consecutive patients treated with extracorporeal membrane oxygenation for refractory postoperative cardiogenic shock","volume":"77","author":"Doll","year":"2004","journal-title":"Ann. Thorac. Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1067\/mtc.2001.114351","article-title":"3rd Clinical experience with 202 adults receiving extracorporeal membrane oxygenation for cardiac failure: Survival at five years","volume":"122","author":"Smedira","year":"2001","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1002\/ejhf.857","article-title":"Extra corporeal membrane oxygenation in the therapy of cardiogenic shock (ECMO-CS): Rationale and design of the multicenter randomized trial","volume":"19","author":"Ostadal","year":"2017","journal-title":"Eur. J. Heart Fail."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1177\/02676591211004363","article-title":"Gender-related propensity score match analysis of ECMO therapy in postcardiotomy cardiogenic shock in patients after myocardial revascularization","volume":"37","author":"Gerfer","year":"2022","journal-title":"Perfusion"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1111\/aor.13844","article-title":"Gender-related differences in treatment and outcome of extracorporeal cardiopulmonary resuscitation-patients","volume":"45","author":"Gaisendrees","year":"2021","journal-title":"Artif. Organs"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1016\/j.amjsurg.2004.07.034","article-title":"Child-Turcotte-Pugh versus MELD score as a predictor of outcome after elective and emergent surgery in cirrhotic patients","volume":"188","author":"Farnsworth","year":"2004","journal-title":"Am. J. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"786","DOI":"10.1007\/s11605-020-04768-3","article-title":"Association of County-Level Social Vulnerability with Elective Versus Non-elective Colorectal Surgery","volume":"25","author":"Diaz","year":"2021","journal-title":"J. Gastrointest Surg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1177\/0391560320987163","article-title":"Emergency versus elective ureteroscopy for the management of ureteral stones","volume":"89","author":"Gadzhiev","year":"2022","journal-title":"Urologia"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1016\/j.ejcts.2008.08.019","article-title":"Thoracic endovascular aortic repair: Impact of urgency on outcome and quality of life","volume":"35","author":"Dick","year":"2009","journal-title":"Eur. J. Cardiothorac. Surg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.jvs.2015.11.054","article-title":"Impact of age and urgency on survival after thoracic endovascular aortic repair","volume":"64","author":"Isernia","year":"2016","journal-title":"J. Vasc. Surg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1002\/ccd.29638","article-title":"Elective versus urgent in-hospital transcatheter aortic valve implantation","volume":"98","author":"Kabahizi","year":"2021","journal-title":"Catheter. Cardiovasc. Interv."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1111\/joic.12323","article-title":"Elective or Emergency Use of Mechanical Circulatory Support Devices During Transcatheter Aortic Valve Replacement","volume":"29","author":"Singh","year":"2016","journal-title":"J. Interv. Cardiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1186\/s13019-017-0618-0","article-title":"Extra-corporeal membrane oxygenation for refractory cardiogenic shock after adult cardiac surgery: A systematic review and meta-analysis","volume":"12","author":"Khorsandi","year":"2017","journal-title":"J. Cardiothorac. Surg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/j.ancard.2020.10.006","article-title":"ECMO for post cardiotomy refractory cardiogenic shock: Experience of the cardiac surgery department of the Grenoble Alpes University Hospital","volume":"70","author":"Benseghir","year":"2021","journal-title":"Ann. Cardiol. Angeiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1186\/s13019-021-01638-0","article-title":"ECMO after cardiac surgery: A single center study on survival and optimizing outcomes","volume":"16","author":"Brewer","year":"2021","journal-title":"J. Cardiothorac. Surg."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1533","DOI":"10.1016\/j.hlc.2021.03.276","article-title":"Concomitant ECMO And IABP Support in Postcardiotomy Cardiogenic Shock Patients","volume":"30","author":"Djordjevic","year":"2021","journal-title":"Heart Lung Circ."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1037","DOI":"10.1111\/jocs.14526","article-title":"Central vs peripheral venoarterial ECMO in postcardiotomy cardiogenic shock","volume":"35","author":"Djordjevic","year":"2020","journal-title":"J. Card. Surg."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1111\/jocs.14332","article-title":"Single center experience with patients on veno arterial ECMO due to postcardiotomy right ventricular failure","volume":"35","author":"Djordjevic","year":"2020","journal-title":"J. Card. Surg."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.1097\/MAT.0000000000001369","article-title":"A Standardized Approach Improves Outcomes of Extracorporeal Membrane Oxygenation for Postcardiotomy Shock","volume":"67","author":"Ogami","year":"2021","journal-title":"ASAIO J."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2662","DOI":"10.1053\/j.jvca.2020.11.003","article-title":"Duration of Venoarterial Extracorporeal Membrane Oxygenation and Mortality in Postcardiotomy Cardiogenic Shock","volume":"35","author":"Mariscalco","year":"2021","journal-title":"J. Cardiothorac. Vasc. Anesth."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1016\/j.athoracsur.2018.05.063","article-title":"Meta-Analysis of Peripheral or Central Extracorporeal Membrane Oxygenation in Postcardiotomy and Non-Postcardiotomy Shock","volume":"107","author":"Raffa","year":"2019","journal-title":"Ann. Thorac. Surg."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Huang, D., Xu, A., Guan, Q., Qin, J., and Zhang, C. (2021). Venoarterial extracorporeal membrane oxygenation with intra-aortic balloon pump for postcardiotomy cardiogenic shock: A systematic review and meta-analysis. Perfusion.","DOI":"10.1177\/02676591211042568"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"2087","DOI":"10.1053\/j.jvca.2018.03.016","article-title":"Clinical Outcomes of Adult Patients Who Receive Extracorporeal Membrane Oxygenation for Postcardiotomy Cardiogenic Shock: A Systematic Review and Meta-Analysis","volume":"32","author":"Wang","year":"2018","journal-title":"J. Cardiothorac. Vasc. Anesth."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1016\/j.emc.2020.06.015","article-title":"Extracorporeal Membrane Oxygenation in the Emergency Department","volume":"38","author":"Badulak","year":"2020","journal-title":"Emerg. Med. Clin. N. Am."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1016\/j.jtcvs.2009.10.043","article-title":"Early and late outcomes of 517 consecutive adult patients treated with extracorporeal membrane oxygenation for refractory postcardiotomy cardiogenic shock","volume":"139","author":"Rastan","year":"2010","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1111\/aor.13067","article-title":"Managing Traps and Pitfalls During Initial Steps of an ECMO Retrieval Program Using a Miniaturized Portable System: What Have We Learned From the First Two Years?","volume":"42","author":"Sabashnikov","year":"2018","journal-title":"Artif. Organs"}],"container-title":["Life"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-1729\/12\/11\/1872\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:17:18Z","timestamp":1760145438000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-1729\/12\/11\/1872"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,13]]},"references-count":36,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2022,11]]}},"alternative-id":["life12111872"],"URL":"https:\/\/doi.org\/10.3390\/life12111872","relation":{},"ISSN":["2075-1729"],"issn-type":[{"value":"2075-1729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,13]]}}}