Original Clinical ScienceUse of a percutaneous temporary circulatory support device as a bridge to decision during acute decompensation of advanced heart failure
Section snippets
Methods
This was a 3-center, retrospective, observational study conducted at Baylor University Medical Center, Tufts Medical Center, and the University of Chicago Medical Center. Data were collected retrospectively by record review. The study was approved by the Institutional Review Board at each center.
Results
Between January 2010 and December 2015, 73 patients received the Impella 5.0 device for hemodynamic support at our 3 centers (Figure 1). The analysis excluded 19 patients due to the absence of pre-existing advanced HF (myocarditis in 7, cardiogenic shock secondary to acute myocardial infarction in 5, and post-cardiotomy cardiogenic shock in 5) or due to inability to implant the device (n = 2). The remaining 58 patients received Impella 5.0 support for acutely decompensated advanced HF and were
Discussion
In this large series of patients with advanced HF and acute hemodynamic instability, the Impella 5.0 stabilized these patients so that candidacy for advanced therapies, such as OHTx, durable LVAD, or palliative care, could be evaluated in a timely manner. This study expands an earlier report to a multicenter setting, including follow-up of all patients to 1 year after explant of the Impella device, and provides an analysis of predictors of survival to next therapy. Specifically, we identified
Disclosure statement
S.A.H. is a consultant for Abiomed Inc. N.K.K. receives research funding from Abiomed Inc., Maquet Inc., and Cardiac Assist Inc. None of the other authors has a financial relationship with a commercial entity that has an interest in the subject of the presented manuscript or other conflicts of interest to disclose.
References (16)
- et al.
Repeated hospitalizations predict mortality in the community population with heart failure
Am Heart J
(2007) - et al.
Clinical outcomes for continuous-flow left ventricular assist device patients stratified by pre-operative INTERMACS classification
J Heart Lung Transplant
(2011) - et al.
2015 SCAI/ACC/HFSA/STS clinical expert consensus statement on the use of percutaneous mechanical circulatory support devices in cardiovascular care: endorsed by the American Heart Association, the Cardiological Society of India, and Sociedad Latino Americana de Cardiologia Intervencion; affirmation of value by the Canadian Association of Interventional Cardiology-Association Canadienne de Cardiologie d’intervention
J Am Coll Cardiol
(2015) - et al.
The RECOVER I: a multicenter prospective study of Impella 5.0/LD for postcardiotomy circulatory support
J Thorac Cardiovasc Surg
(2013) - et al.
The Impella device for acute mechanical circulatory support in patients in cardiogenic shock
Ann Thorac Surg
(2014) - et al.
Effectiveness and safety of the Impella 5.0 as a bridge to cardiac transplantation or durable left ventricular assist device
Am J Cardiol
(2016) - et al.
The right axillary artery approach for the Impella Recover LP 5.0 microaxial pump
Ann Thorac Surg
(2008) - et al.
Cardiac power output predicts mortality across a broad spectrum of patients with acute cardiac disease
Am Heart J
(2007)
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2022, American Journal of CardiologyCitation Excerpt :Percutaneous mechanical circulatory support (pMCS) devices have been increasingly used in cardiogenic shock (CS) because of acute myocardial infarction (AMI) or acutely decompensated heart failure (ADHF).1,2