The use of active mechanical circulatory support is growing rapidly around the world. The hope is that these systems will improve survival after the most severe form of acute heart failure, cardiogenic shock.
For more than a decade, patients have often been treated with venoarterial extracorporeal membrane oxygenation , which is also called extracorporeal life support . This mechanical circulatory support helps the diseased heart to pump blood around the body. ECLS can theoretically take over the function of the heart and lungs for a period of time.
Professor Holger Thiele, Medical Director of the Heart Center Leipzig at Leipzig University and President of the German Cardiac Society, has now conducted a large clinical trial involving a total of 420 patients at 44 centers in Germany and Slovenia.
The results were further confirmed by an individual patient-based meta-analysis comparing the results of all four previous studies involving mechanical cardiovascular support with venoarterial extracorporeal membrane oxygenation versus control. Again, ECLS did not improve survival, but it was associated with more complications.
"The results of the trial show that there is a need to reduce the frequency of ECLS therapy in Germany and internationally. It is likely that future guidelines will soon take this into account and downgrade the recommendation for activedevices or even stop recommending it altogether in routine practice," says Professor Thiele.
The heart specialist is planning many more follow-up trials, including a one-year follow-up to see if there are any differences over time.
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