Table 1.

Patient baseline characteristics

	Age & Gender	Date of surgery	Original operation	Duration and Mode of AMCS	AMCS Complication/s	Outcome
Patient 1	76 year old male	2012	Re-do sternotomy and AVR	Salvage peripheral VA ECMO due to postoperative pulmonary haemorrhage and cardiogenic shock	Femoral artery cannulation site pseudoaneurysm	Alive
						NYHA I (No breathlessness of exertion, back to work)
					Major haemorrhage from cannulation site
Patient 2	40 year old male	2014	Re-do, Re-do sternotomy for type A aortic dissection: Bentall procedure	Salvage RVAD due to VF arrest and severe LVSD after weaning from CPB	Major haemorrhage and re-exploration in the operating theatre	Alive
						NYHA II (Breathless on exertion)
Patient 3	82 year old male	2006	MV Repair and CABG	3 Days	Could not be weaned from ECMO with severe biVent failure and	Died in CTICU
				VA ECMO as unable to wean from CPB		COD: BiVent failure
Patient 4	72 year old Female	2011	AVR	9 Days	Septic shock	Died in CTICU
				VA ECMO as unable to come off CPB	Limb ischaemia	COD: Septic shock
Patient 5	71 year old male	2011	CABG and AVR	2 Days	ECMO cannulation site bleeding and haematoma explored	Died in CTICU
				Peripheral VA ECMO as unable to come off CPB		COD: Shock (unknown cause)
					Renal failure a
Patient 6	83 year old female	2012	MVR and CABG	<1 Day	None	Died in CTICU
				Peripheral VA ECMO as unable to wean from CPB		COD: BiVent failure
Patient 7	70 year old male	2013	Re-do sternotomy and AVR	33 Days	Major CVA	Died in HDU
				VA ECMO for cardiac failure. Successfully weaned from ECMO		COD: severe Respiratory failure
Patient 8	72 year old male	2013	Re-do sternotomy and AVR	<1 Day	ECMO cannulation femoral artery dissection	Died in CTICU
				VA ECMO after iatrogenic aortic dissection leading to cardiogenic shock during Femoral cannulation for CPB		COD: Major CVA
					Major haemorrhage
					Major CVA
Patient 9	51 year old male	2013	Re-suspension of Aortic valve and repair of type A aortic dissection	1 Day	Major cannulation site haemorrhage	Died in CTICU
				Peripheral VA ECMO for cardiogenic shock		COD: Haemorrahgic shock and BiVent failure
Patient 10	34 year old female	2014	IVC Leiomyosarcoma resection	3 Days	None	Died in CTICU
				VA ECMO for postoperative cardiogenic shock for intraoperative MI		COD: BiVent failure from acute MI
Patient 11	65 year old male	2013	CABG	2 Days	Renal failurea	Died in CTICU
				Salvage VA ECMO for cardiogenic shock	Hepatic failure	COD: MODS
					Pulmonary oedema
Patient 12	71 year old male	2015	CABG	3 Days	Major haemorrhag e: Re-opening for bleeding x4	Died in CTICU
				VA ECMO as unable to wean from CPB		COD: biventricular failure and septic shock
					limb ischaemia
Patient 13	49 year old male	1997	CABG	VA ECMO as unable to wean from CPB	Note recorded	Alive
						(Died 2004)
						NYHA II
Patient 14	69 year old male	2004	MVR and CABG for mitral valve IE	VA ECMO as unable to wean from CPB	CVA and seizures	Alive
					Renal failure a	NYHA II
Patient 15	41 year old female	2005	Aortic transection and diaphragm rupture	VA ECMO	Not recorded	Alive
						NYHA I
Patient 16	59 year old male	2006	Type A aortic dissection	2 Days	Not recorded	Died
				Peripheral VA ECMO as unable to wean from CPB		COD: Bivent failure
Patient 17	21 year old male	2014	AVR	3 days	ECMO cannulation site bleeding-required re-exploration	Alive
				Peripheral VA ECMO		NYHA I
					Cardiac tamponade
Patient 18	51 year old male	2014	AVR	6 days	CVA and Seizures	Died in ICU
				Peripheral VA ECMO	limb ischaemia	COD: status epilepticus
Patient 19	46 year old male	2014	CABG	2 days	Major haemorrahage	Died in ICU
				Peripheral VA ECMO converted to central VA ECMO due to peripheral ischaemia		COD: MODS
					Limb ischaemia/compartment syndrome-bilateral fasciotomies
					Renal failurea
Patient 20	54 year old male	2015	CABG and AVR	3 days	SVT/VT	Alive
				VA ECMO for cardiogenic shock	Major intra-abdominal haemorrhage requiring laparotomy	NYHA II (Neuropathic leg pain)
					Limb ischaemia
Patient 21	56 year old male	2015	AVR	3 days	CVA (occipital infarcts)	Alive
				Peripheral VA ECMO for cardiogenic shock		NYHA I (Visual difficulties)
Patient 22	64 year old male	2015	AVR	1 day	Vasoplegia	Died
				VA ECMO	MODS	COD: AV dissociation
Patient 23	52 year old male	2015	CABG	1 day	MODS	Died
				VA ECMO		COD: MODS
Patient 24	64 year old male	2015	AVR	7 days	None	Alive
				VA ECMO		NYHA I
Patient 25	50 year old male	2014	AVR	23 days	Renal failurea	Alive
				BiVAD		NYHA I
					Haemothorax/mediastinal collection requiring re-operation
Patient 26	54 year old male	2015	Bentall’s procedure and CABG surgery	2 days	Hepatic failure	COD: MODS
				LVAD acute LV failure	Renal failure pleasea
Patient 27	61 year old male	2003	CABG	11 days	Respiratory failure	Alive
				LVAD for acute LV failure	Renal failurea	NYHA II

Abbreviations: ACS Acute coronary syndrome, AF atrial fibrillation, AMCS Advanced mechanical circulatory support, AVR Aortic valve replacement, CABG Coronary artery bypass grafting surgery, CPB Cardiopulmonary bypass, COD cause of death, BiVent failure BiVentricular failure, MVR Mitral valve replacement, IE Infective endocarditis, CVA Cerebrovascular accident, IVC Inferior vena-cava, NYHA New York Heart Association, CTICU cardiothoracic Intensive care unit, HDU High dependency unit, Implantable cardioverter defibrillator, MI Myocardial infarction, LVSD Left ventricular systolic dysfunction, TVD triple vessel coronary artery disease, LV left ventricular, MR Mitral regurgitation, PVD Peripheral vascular disease, MODS Multi-organ dysfunction syndrome, VF Ventricular fibrillation, VAD Ventricular assist device, VA Veno-Arterial

^aAll patients with renal failure required renal replacement therapy