Viability-guided, extracorporeal membrane oxygenation (ECMO) supported high-risk coronary intervention results in early clinical and functional benefit in severe ischemic cardiomyopathy - Results of a pilot project

1813 Objectives It is assumed that the importance of viability detection for guidance of therapy increases as a function of increasing procedure-related risk and increasing severity of cardiac dysfunction. In a pilot project, we employed viability imaging to guide a novel therapeutic approach in acutely decompensated, severe ischemic cardiomyopathy. Methods In patients requiring intensive care for stabilization of acutely decompensated, severe ischemic cardiomyopathy (n=5; LVEF Results At baseline SPECT/PET, LVEF was 17±5% and perfusion defect score (SRS) was 27±15. Extent of perfusion/metabolism mismatch was 37±15% of LV, and extent of scar was 20±25%. At follow-up, LVEF increased to 29±7% (p=.04) and SRS decreased to 21±14 (p Conclusions Viability-guided high-risk multi-vessel PCI under ECMO protection is safe in acutely decompensated, severe ischemic cardiomyopathy. Serial SPECT/PET imaging suggests an early and substantial functional benefit