Mechanical circulatory support with the Impella 5.0 device for postcardiotomy cardiogenic shock: a three-center experience
2013 (English)In: Minerva Cardioangiologica: Journal on Cardiovascular Pathophysiology, Clinical Medicine and Therapy, ISSN 0026-4725, Vol. 61, no 5, 539-546 p.Article in journal (Refereed) Published
Postcardiotomy cardiogenic shock (PCCS) is associated with high mortality rates, despite full conventional treatment. Although the results of treatment with surgically implantable ventricular assist devices have been encouraging, the invasiveness of this treatment limits its applicability. Several less invasive devices have been developed, including the Impella system. The objective of this study was to describe our three-center experience with the Impella 5.0 device in the setting of PCCS.
From January 2004 through December 2010, a total of 46 patients were diagnosed with treatment-refractory PCCS and treated with the Impella 5.0 percutaneous left ventricular assist device at three european heart centers. Baseline and follow-up characteristics were collected retrospectively and entered into a dedicated database.
Within the study cohort of 46 patients, mean logistic and additive EuroSCORES were 24 ± 19 and 10 ± 4. The majority of patients underwent coronary artery bypass grafting (48%) or combined surgery (33%). Half of all patients had been treated with an intra-aortic balloon pump before 5.0-implantation, 1 patient had been treated with an Impella 2.5 device. All patients were on mechanical ventilation and intravenous inotropes. The Kaplan-Meier estimate of overall 30-day survival was 39.5%.
Thirty-day survival rates for patients with PCCS, refractory to aggressive conventional treatment and treated with the Impella 5.0 device, are comparable to those reported in studies evaluating surgically implantable VADs, whereas the Impella system is much less invasive. Therefore, mechanical circulatory support with the Impella 5.0 device is a suitable treatment modality for patients with severe PCCS.
Place, publisher, year, edition, pages
Edizione Minerva Medica , 2013. Vol. 61, no 5, 539-546 p.
Shock, cardiogenic, Cardiac surgical procedures, Surgical procedures, operative
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:liu:diva-102786ISI: 000327753600005PubMedID: 24096248OAI: oai:DiVA.org:liu-102786DiVA: diva2:683868
Funding Agencies|Abiomed Europe GmbH||2014-01-072013-12-262014-01-24Bibliographically approved