Back to Annual Meeting Program

Background: Acute cardiogenic shock is associated with high mortality rates. Mechanical circulatory devices have been increasingly used in this setting for hemodynamic support. The Impella device (Abiomed Inc., Danvers, MA) is a microaxial LVAD that can be inserted using a less invasive technique. The purpose of this study is to determine the outcome of patients who have undergone the placement of the Impella device for acute cardiogenic shock in our institution.
Methods: A retrospective chart review of 36 patients who underwent placement of the Impella device was performed from January 1^st, 2006 to December 31^st, 2010. Charts were evaluated for demographics, operative details and postoperative outcomes. Operative mortality was defined as death within 30-days of surgery.
Results: The average age of the patients was 60.27 ±13 and the majority of the patients were male (N=25). The indication for placement of the Impella device include cardiogenic shock in 19 (52%), acute myocardial infarction in 4 (11%), ischemic cardiomyopathy in 3 (8%), and other indications in 10 (28%). Twenty-eight patients of the 36 total patients (78%) had the Impella 5.0 and the rest the 2.5 device. The majority of the patients, 25 of 36 (69%), recovered ventricular function and had the device removed with 3 patients (8%) transitioned to long-term ventricular assist devices. The 30-day mortality was 25%. Complications occurred in 14 of the 36 patients (38%) and consisted of device malfunction, high purge pressures, tube fracture, and groin hematoma.
Conclusion: This is the largest series of patients undergoing placement of the Impella device for acute cardiogenic shock. The outcomes from our study have results which are improved over historical data. Myocardial recovery was accomplished in the majority of the patients. Finally the
30-day mortality and complication rate was acceptable in these critical patients. These benefits were all achieved with the Impella device in a less invasive method.