Impella – Current issues and future expectations for the percutaneous, microaxial flow left ventricular assist device

Saito, Shunsuke; Okubo, Shohei; Matsuoka, Taiki; Hirota, Shotaro; Yokoyama, Shohei; Kanazawa, Yuta; Takei, Yusuke; Tezuka, Masahiro; Tsuchiya, Go; Konishi, Taisuke; Shibasaki, Ikuko; Ogata, Koji; Fukuda, Hirotsugu

doi:10.1016/j.jjcc.2023.10.008

Cited by 4 publications

(3 citation statements)

References 65 publications

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“…The most common complications associated with the use of Impella are: hemolysis, bleeding at the insertion site, arrhythmias, thrombocytopenia, aortic valve or mitral apparatus injury, vascular injury, limb ischemia, device malfunction, site infections and acute brain injury (embolic stroke). 22 …”

Section: Complications Associated With Use Of Impellamentioning

confidence: 99%

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What the pediatric nurse needs to know about the Impella cardiac assist device

Borrelli,

Nittolo,

Bochicchio

et al. 2024

Perfusion

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Background: Cardiogenic shock in children still carries a high mortality risk despite advances in medical therapy. The use of temporary mechanical circulatory supports is an accepted strategy to bridge patients with acute heart failure to recovery, decision, transplantation or destination therapy. These devices are however limited in children and extracorporeal membrane oxygenation (ECMO) remains the most commonly used device. Veno-arterial ECMO may provide adequate oxygen delivery, but it does not significantly unload the left ventricle, and this may prevent recovery. To improve the likelihood of left ventricular recovery and minimize the invasiveness of mechanical support, the Impella axial pump has been increasingly used in children with acute heart failure in the last decade. Purpose: There are still limited data describing the Impella indications, management and outcomes in children, therefore, we aimed to provide a comprehensive narrative review useful for the pediatric nurses to be adequately trained and acquire specific competencies in Impella management.

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Section: Complications Associated With Use Of Impellamentioning

confidence: 99%

“…The occurrence of stroke is rare in children supported with Impella, 1 , 3 however, embolization of clots around the pump may happen and should be properly monitored. 22 …”

Section: Complications Associated With Use Of Impellamentioning

confidence: 99%

What the pediatric nurse needs to know about the Impella cardiac assist device

Borrelli,

Nittolo,

Bochicchio

et al. 2024

Perfusion

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“…In the United States, long-term LVADs are rarely used as BTT. Instead, short-term devices such as Micro-axial flow pumps are preferred due to their less invasive nature compared to other MCS devices [ 99 ]. For example, Impella 5.5 as a BTT demonstrated a 1-year survival rate of 89.5% [ 100 ].…”

Section: Future Perspectives and Innovations Of Bttmentioning

confidence: 99%

LVAD as a Bridge to Transplantation—Current Status and Future Perspectives

Roesel,

Nersesian,

Neuber

et al. 2024

Rev. Cardiovasc. Med.

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Heart failure (HF) is a common disease associated with high morbidity and mortality rates despite advanced pharmacological therapies. Heart transplantation remains the gold standard therapy for end-stage heart failure; however, its application is curtailed by the persistent shortage of donor organs. Over the past two decades, mechanical circulatory support, notably Left Ventricular Assist Devices (LVADs), have been established as an option for patients waiting for a donor organ. This comprehensive review focuses on elucidating the benefits and barriers associated with this application. We provide an overview of landmark clinical trials that have evaluated the use of LVADs as a bridge to transplantation therapy, with a particular focus on post-transplant outcomes. We discuss the benefits of stabilizing patients with these systems, weighing associated complications and limitations. Further technical advancements and research on optimal implantation timing are critical to ultimately improve outcomes and securing quality of life. In a world where the availability of donor organs remains constrained, LVADs are an increasingly important piece of patient care, bridging the critical gap to transplantation in advanced heart failure management.

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