Surgically implanted endovascular, microaxial left ventricular assist device: A single institution study

• Published in: JTCVS techniques 2024-02, Vol.23, p.63-71
• Main Authors: Schumer, Erin M., Bai, Yun Zhu, Kotkar, Kunal D., Masood, M. Faraz, Itoh, Akinobu, Schilling, Joel D., Ewald, Gregory A., Damiano, Marci S., Fischer, Irene, Kaneko, Tsuyoshi, Damiano, Ralph J., Pawale, Amit
• Format: Article
• Language: English
• Subjects: Adult: Mechanical Circulatory Support; cardiogenic shock; temporary mechanical circulatory support; ventricular assist device
• ISSN: 2666-2507; 2666-2507
• DOI: 10.1016/j.xjtc.2023.10.012

The Impella 5.5 (Abiomed, Inc), a surgically implanted endovascular microaxial left ventricular assist device, is increasingly used worldwide and there have been more than 10,000 implants. The purpose of this study is to describe a large-volume, single-center experience with the use of the Impella 5.5. Data were obtained retrospectively from patients supported with the Impella 5.5 implanted at our institution from May 1, 2020, to December 31, 2022. Demographic, operative, and postoperative outcomes for each group are described. Results are reported in median (interquartile range) or n (%). The entire cohort was divided into 5 main groups based on the intention to treat at the time of the Impella 5.5 implantation: (1) patients who had a planned Impella 5.5 implanted at the time of high-risk cardiac surgery; (2) patients with cardiogenic shock; (3) patients bridged to a durable left ventricular assist device; (4) patients bridged to transplant; and (5) patients with postcardiotomy shock who received an unplanned Impella 5.5 implant. A total of 126 patients were supported with the Impella 5.5. Overall survival to device explant was 76.2%, with 67.5% surviving to discharge. Midterm survival was assessed with a median follow-up time of 318 days and demonstrated an overall survival of 60.3% and a median of 650 days (549-752). Outcomes after using the Impella 5.5 are variable depending on the indication of use. Patient selection may be of utmost importance and requires further experience with this device to determine who will benefit from insertion. [Display omitted]