Single-center 4-years Experience with Impella 5.5 Left Ventricular Assist Device in an All-comers Population

10104 

Abstract Submission 

Tommaso Cambiaghi (1), Fatima Qamar (1), Therese Hoof (1), Memhet Akay (1)

(1) Houston Methodist, Houston, TX

Tommaso Cambiaghi    -  Contact Me
Houston Methodist

Fatima Qamar    -  Contact Me
Houston Methodist

Therese Hoof    -  Contact Me
Houston Methodist

Memhet Akay    -  Contact Me
Houston Methodist

Fatima Qamar    -  Contact Me
N/A

Objective:
The objective of this single center study was to evaluate the clinical efficacy and safety of the use of Impella 5.5 in patients in cardiogenic shock or end-stage cardiomyopathy as bridge to destination therapy, focusing on peri-procedural outcomes and short-term clinical endpoints.

Methods:
This retrospective observational study included all patients who underwent Impella 5.5 support between February 2020 and March 2024. Data collection included baseline demographics, risk factors, procedural details, and clinical outcomes such as mortality, complications related to Impella use and ability to wean from mechanical circulatory support or effectively bridge to transplant or implantable left ventricular assist device (LVAD). Statistical analysis included descriptive statistics and appropriate inferential tests for comparison between groups.

Results:
A total of 145 patients (mean age 57.7, 88% male) were included in the analysis. The primary indication for mechanical circulatory support was acute cardiogenic shock in 59% of patients, cardiomyopathy in 33%, acute coronary syndrome in 7%, and post-cardiotomy shock in 1%. Median Impella support duration was 24 days (IQR 12-51 days)

65% of patients were successfully weaned off Impella mechanical circulatory support, 14% of them to medical therapy alone, 16% were bridged to LVAD implant, and 35% to heart transplant. Of note 3 of the patients bridged to LVAD therapy eventually received a heart transplant within the short follow-up period.

In-hospital mortality and 30-day mortality were 25% and 23% respectively. New strokes during Impella therapy occurred in 10% of patients, bleeding at insertion site in 7% of patients and access-related limb ischemia in 3%.

Conclusions:
In conclusion, our study demonstrates that Impella provides effective hemodynamic support in high-risk patients with cardiogenic shock or end-stage cardiomyopathy, significantly improving their outcomes and chances to reach destination therapy.

ECMO/Mechanical Support