• Jennifer Higgins, Yoan Lamarche, Annemarie Kaan, Louis-Mathieu Stevens, and Anson Cheung.
• Division of Cardiac Surgery, St Paul's Hospital and University of British Columbia, Vancouver, British Columbia, Canada.
• Can J Cardiol. 2011 Nov 1; 27 (6): 725-30.

BackgroundImpella microaxial devices provide circulatory assistance for patients with acute decompensated heart failure. This study reviews the population-based provincial experience in British Columbia.MethodsWe performed a retrospective review of the prospectively maintained database. Impella devices were inserted for acute cardiogenic shock refractory to maximal therapy, as a bridge to decision or to long-term mechanical support.ResultsBetween August 2007 and September 2009, 35 patients received 37 Impella devices (Impella LP 2,5, n=2; Impella LP 5,0, n=29; and Impella RD 5.0, n=6) (Abiomed Inc, Danvers, MA). Devices were inserted in the setting of dilated cardiomyopathy (n=13), acute myocardial infarction (n=6), postcardiotomy shock (n=6), and other etiologies (n=12). Mean age was 53.0±13.7 years. Mean left ventricular ejection fraction was 19±9% at the time of insertion. Nineteen patients required aggressive resuscitation, all patients were on inotropic support, 97% of patients were intubated, and 46% of patients received mechanical circulatory support prior to insertion of the Impella devices. Mean duration of support was 3.7±3.0 days. In all, 49% were successfully weaned, and 22% were transferred to long-term mechanical support. Four patients have subsequently undergone successful cardiac transplantation. The 30-day mortality was 40%, and 6-month mortality was 49%. Complications included gastrointestinal bleeding (n=1), hemoptysis (n=1), and thrombocytopenia (n=4). There were no cardiovascular or cerebrovascular events.ConclusionTemporary support with Impella microaxial ventricular assist devices adds a valuable therapeutic option in selected patients with acute decompensated heart failure.Copyright © 2011 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

29 keywords...

hide…