Single center first year experience and outcomes with Impella 5.5 left ventricular assist device

Abstract

Background The Impella 5.5® was approved by the FDA for use for mechanical circulatory support up to 14 days in late 2019 at limited centers in the United States. Our single center’s experience with Impella 5.5® can expand the overall understanding for achieving successful patient outcomes as well as provide support for the expansion of its FDA-approved use. Methods This study is an IRB-approved single-center retrospective cohort analysis of hospitalized adult patient characteristics and outcomes in cases where the Impella 5.5® was utilized for mechanical circulatory support. Results A total of 26 implanted Impella 5.5® devices were identified in 24 hospitalized patients at our institution from January 2020 to January 2021. The overall survival rate during index hospitalization was 75%. Eleven Impella 5.5® devices were identified in 10 patients with an average device implantation greater than 14 days. Average device implantation for this subgroup was 27 days with a range of 15–80 days. Survival rate for Impella 5.5® use greater than 14 days was 67%. In the entire cohort and subgroup of device implantation > 14 days, evidence of end organ damage improved with Impella 5.5® use. Complications in our cohort and subgroup of device implantation > 14 days were similar to previously reported complication incidence of axillary inserted LVAD devices. Conclusions Our institution’s experience with the Impella 5.5® has been strongly positive with favorable outcomes and helps to establish the Impella 5.5® as a viable option for mechanical circulatory support beyond 14 days.

Cardiogenic shock etiology and exit strategy impact survival in patients with Impella 5.5

“…The overall survival in our study is similar to that shown in prior single-center Impella 5.5 studies. 12…”

“…Impella 5.5 support has shown initial promise as a CS intervention in early analyses, however thorough comparison of Impella 5.5 outcomes in AMI-CS and ADHF-CS has yet to be published. 4,[11][12][13][14][15][16] Therefore, we aim to investigate initial presentation, clinical course, and outcomes for CS patients treated with Impella 5.5 at our center stratified by CS etiology.…”

Temporary mechanical circulatory support & enhancing recovery after cardiac surgery

“…tMCS options include intra-aortic balloon pump (IABP), centrifugal flow (CF), and microaxial flow (MAF) devices [38,39]. Although this review emphasizes tMCS and left ventricular failure, ERASC principles also apply to right ventricular [40,41], biventricular, respiratory support via the addition of an extracorporeal membrane oxygenator (ECMO) [42], as well as 'ECPELLA' or 'EMPELLA' (a hybrid combination where ECMO and a MAF device are combined) [43,44].…”

Pathophysiology and Management of Heart Failure in the Elderly

“…115 The Impella 5.5 is another ventricular assist device that has been approved to provide mechanical circulatory support up to 14 days in drug-refractory advanced HF patients. 116 117 The CorCap Cardiac Support Device, which is a mesh-like surgical device implanted around the heart, decreased LV end-diastolic dimension and increased LV ejection fraction in HF patients. 118 On the contrary, the Revinent TC System (BioVentrix Inc) provides a less invasive approach for altering LV dimensions in selected HF patients with ischemic cardiomyopathy.…”