PMID- 37039780
OWN - NLM
STAT- MEDLINE
DCOM- 20230703
LR  - 20231116
IS  - 1538-943X (Electronic)
IS  - 1058-2916 (Linking)
VI  - 69
IP  - 7
DP  - 2023 Jul 1
TI  - Extended Support With the Impella 5.5: Transplant, ECMO, and Complications.
PG  - 642-648
LID - 10.1097/MAT.0000000000001931 [doi]
AB  - We report midterm results of Impella 5.5 use with focus placed on 
      bridge-outcomes, venoarterial extracorporeal membrane oxygenation (VA-ECMO) 
      transition, complications, and risk factors for mortality. A retrospective review 
      of patients implanted with the Impella 5.5 at our medical center was conducted. 
      Forty patients were included with varying bridge strategies. Sixteen (40%) 
      patients were supported for <14 days, 13 (32.5%) for 14-30 days, and 11 (27.5%) 
      for >30 days. Thirty day mortality was 22.5% (9/40). Twenty-five (62.5%) were 
      successfully bridged to transplant or durable left ventricular assist device 
      (LVAD), while four (10.0%) recovered without the need for any further cardiac 
      support. Five of 11 (60%) patients initially supported with VA-ECMO were either 
      transitioned to durable left ventricular assist device (dLVAD; n = 3, 27.3%), 
      transplanted (n = 1, 9.1%), or recovered (n = 1, 9.1%). Of nine patients with 
      >moderate right ventricle (RV) dysfunction, five (55.6%) were successfully 
      bridged to transplant or LVAD. Five (12.5%) patients required interval 
      cannulation to VA-ECMO, often in the setting of RV dysfunction, and all (100%) 
      were successfully transplanted. Lower pulmonary artery (PA) systolic pressure ( P 
      = 0.029), among other factors, was associated with mortality. In summary, the 
      Impella 5.5 may be able to effectively stabilize patients in refractory left 
      ventricular predominant cardiogenic shock for extended durations, allowing time 
      for mechanical circulatory support (MCS) and transplant evaluations.
CI  - Copyright (c) ASAIO 2023.
FAU - Cohen, William G
AU  - Cohen WG
AUID- ORCID: 0000-0002-2623-3510
AD  - From the Department of Medicine, Perelman School of Medicine at the University of 
      Pennsylvania, Philadelphia, Pennsylvania.
FAU - Rekhtman, David
AU  - Rekhtman D
AD  - From the Department of Medicine, Perelman School of Medicine at the University of 
      Pennsylvania, Philadelphia, Pennsylvania.
FAU - Iyengar, Amit
AU  - Iyengar A
AD  - Division of Cardiovascular Surgery, Hospital of the University of Pennsylvania, 
      Philadelphia, Pennsylvania.
FAU - Shin, Max
AU  - Shin M
AD  - From the Department of Medicine, Perelman School of Medicine at the University of 
      Pennsylvania, Philadelphia, Pennsylvania.
FAU - Ibrahim, Michael
AU  - Ibrahim M
AD  - From the Department of Medicine, Perelman School of Medicine at the University of 
      Pennsylvania, Philadelphia, Pennsylvania.
AD  - Division of Cardiovascular Surgery, Hospital of the University of Pennsylvania, 
      Philadelphia, Pennsylvania.
FAU - Bermudez, Christian
AU  - Bermudez C
AD  - From the Department of Medicine, Perelman School of Medicine at the University of 
      Pennsylvania, Philadelphia, Pennsylvania.
AD  - Division of Cardiovascular Surgery, Hospital of the University of Pennsylvania, 
      Philadelphia, Pennsylvania.
FAU - Cevasco, Marisa
AU  - Cevasco M
AD  - From the Department of Medicine, Perelman School of Medicine at the University of 
      Pennsylvania, Philadelphia, Pennsylvania.
AD  - Division of Cardiovascular Surgery, Hospital of the University of Pennsylvania, 
      Philadelphia, Pennsylvania.
FAU - Wald, Joyce
AU  - Wald J
AD  - From the Department of Medicine, Perelman School of Medicine at the University of 
      Pennsylvania, Philadelphia, Pennsylvania.
AD  - Division of Cardiovascular Medicine, Hospital of the University of Pennsylvania, 
      Philadelphia, Pennsylvania.
LA  - eng
PT  - Journal Article
DEP - 20230410
PL  - United States
TA  - ASAIO J
JT  - ASAIO journal (American Society for Artificial Internal Organs : 1992)
JID - 9204109
SB  - IM
MH  - Humans
MH  - *Extracorporeal Membrane Oxygenation/methods
MH  - Shock, Cardiogenic/surgery/etiology
MH  - *Heart-Assist Devices/adverse effects
MH  - Retrospective Studies
MH  - *Heart Transplantation/adverse effects
MH  - *Cardiomyopathies
COIS- Disclosures: J.W. sits on the Abbott advisory board. M.C. is a consultant for 
      Abiomed. C.B. sits on the Abbott and Abiomed advisory boards. The other authors 
      have no conflicts of interest to report.
EDAT- 2023/04/12 06:00
MHDA- 2023/07/03 06:41
CRDT- 2023/04/11 10:53
PHST- 2023/07/03 06:41 [medline]
PHST- 2023/04/12 06:00 [pubmed]
PHST- 2023/04/11 10:53 [entrez]
AID - 00002480-202307000-00002 [pii]
AID - 10.1097/MAT.0000000000001931 [doi]
PST - ppublish
SO  - ASAIO J. 2023 Jul 1;69(7):642-648. doi: 10.1097/MAT.0000000000001931. Epub 2023 
      Apr 10.