Thesis (Ph.D)-Cairo University, 2023.

Bibliography: pages 109-118.

The study is designed to assess the impact of hemodynamic
support by V-A ECMO during high-risk PCI, if it shows advantages to
maintain perfusion and management of any complications during the
procedure.
Objectives: use of VA ECMO as a hemodynamic support for complete
myocardial revascularization of high-risk patients.
Subjects and methods: A prospective interventional study will be
performed on patients with viable ischemic myocardium, syntax score>22,
excluding scarred myocardium and refused CABG. Hemodynamic support
will be done during elective high-risk PCI procedure by connecting patients
on V-A ECMO (Fem-Fem configuration), compared to patients had high risk
PCI without mechanical circulatory support.
Group 1(Study group): 10 patients underwent high risk PCI on V-A ECMO
support.
Group 2(Control group): 10 patients underwent high risk PCI without V-A
ECMO support.
Results: A case-control study total of 20 patients were identified, 10 patients
underwent high risk PCI on V-A ECMO support other group (Control group)
10 patients underwent high risk PCI without V-A ECMO support. Group 1:
mean age 59, mean EF 30.90%, 5 diabetic, 6 hypertensive, 4 patients had LM
lesion, average of 3.9 stents, 1 patient had VT during PCI, 6 patients needed
vasopressors and inotropic support, 7 patients needed surgical decannulation,
3 patients used vascular closure device, 4 patients needed invasive mechanical
ventilation during PCI, 8 patients had complete revascularization in one
session, 10 patients were successfully weaned off V-A ECMO support just
after PCI, average ECLS duration 2.5 hrs. all patients were successfully
discharged home within 1 week.
Conclusion: V-A ECMO showed beneficial supportive rule for
hemodynamics during high-risk PCI, minimizing risks during procedure and
maintaining perfusion, high volume studies are needed to confirm benefits
over conventional treatment.

حالات القصور بالشرايين التاجيه المعقده و الدقيقه مع ضعف شديد بعضله القلب يجعل التدخل الجراحي و القسطره التداخليه عاليه
الخطوره لهولاء المرضي , فأن هذه الدراسة تهدف الى دراسة الفوائد من استخدام جهاز الاكسجة الغشائية خارج الجسم وريدي
شرياني لدعم ديناميكا الدم اثناء القيام بقسطرة تداخليه عالية الخطورة على الشرايين التاجية, تمت الدراسة بشكل استعادى لبيانات
المرضى بمستشفيات جامعه القاهرة, تم تقسيم المرضى الى مجموعتين , تلقت المجموعه الاولى البروتوكول العلاجى المتبع طبقا
لبروتوكولات وزارة الصحة المصرية و الارشادات العالمية و تم مقارنة النتائج بين المجموعتين

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Text in English and abstract in Arabic & English.