High Flow From Impella 5.5 With Partial Veno-Arterial Extracorporeal Membrane Oxygenation Support: Case Series

Authors

• Suguru Ohira, Division of Cardiothoracic Surgery, Department of Surgery, Westchester Medical Center, New York Medical College, Valhalla, New York, USA.Follow
• Stephen Pan, Department of Cardiology, Westchester Medical Center, New York Medical College, Valhalla, New York, USA.Follow
• Avi Levine, Department of Cardiology, Westchester Medical Center, New York Medical College, Valhalla, New York, USA.Follow
• Syed A. Haidry, Department of Cardiology, Westchester Medical Center, New York Medical College, Valhalla, New York, USA.
• Chhaya Aggawal-Gupta, Department of Cardiology, Westchester Medical Center, New York Medical College, Valhalla, New York, USA.
• Gregg Lanier, Department of Cardiology, Westchester Medical Center, New York Medical College, Valhalla, New York, USA.Follow
• Alan Gass, Department of Cardiology, Westchester Medical Center, New York Medical College, Valhalla, New York, USA.Follow
• Corazon De La Pena, Division of Cardiothoracic Surgery, Department of Surgery, Westchester Medical Center, New York Medical College, Valhalla, New York, USA.
• Joshua B. Goldberg, Division of Cardiothoracic Surgery, Department of Surgery, Westchester Medical Center, New York Medical College, Valhalla, New York, USA.Follow
• David Spielvogel, Division of Cardiothoracic Surgery, Department of Surgery, Westchester Medical Center, New York Medical College, Valhalla, New York, USA.Follow
• Masashi Kai, Division of Cardiothoracic Surgery, Department of Surgery, Westchester Medical Center, New York Medical College, Valhalla, New York, USA.Follow

Author Type(s)

Faculty

DOI

10.1111/aor.14183

Journal Title

Artificial Organs

First Page

1198

Last Page

1203

Document Type

Article

Publication Date

6-1-2022

Department

Surgery

Second Department

Medicine

Keywords

EC-PELLA, Impella, cardiogenic shock, extracorporeal membrane oxygenation

Disciplines

Medicine and Health Sciences

Abstract

Optimal flow balance between Impella 5.5 and veno-arterial extracorporeal membrane oxygenation (ECMO) support in the setting of EC-PELLA (ECMO+Impella) is unknown. Outcomes of high Impella 5.5 flow in the setting of EC-PELLA support were reviewed (N = 7). EC-PELLA was successfully explanted in 6 patients (bridge-to-transplant, N = 1; bridge-to-recovery, N = 5). The median duration of EC-PELLA support in explanted patients was 6 days. Survival at discharge was 71.4% (5 patients). In terms of device-related events, either VA-ECMO or Impella-related complications were not experienced. The median performance level of Impella 5.5 was P5 at the time of starting EC-PELLA support and then increased with time up to the median of P8 with increment of the Impella flow, and index (L/min/m ). The percentage of Impella flow per total EC- PELLA flow reached 50% after 48 h of support. The vasoactive-inotropic score and serum lactate level improved after institution of EC-PELLA support as well as the pulmonary artery pressures and central venous pressure. In conclusion, a high pump flow from Impella 5.5 with partial VA-ECMO support in the setting of EC-PELLA provided great support with favorable survival and device-related complications rate.

Recommended Citation

Ohira, S., Pan, S., Levine, A., Haidry, S. A., Aggawal-Gupta, C., Lanier, G., Gass, A., De La Pena, C., Goldberg, J. B., Spielvogel, D., & Kai, M. (2022). High Flow From Impella 5.5 With Partial Veno-Arterial Extracorporeal Membrane Oxygenation Support: Case Series. Artificial Organs, 46 (6), 1198-1203. https://doi.org/10.1111/aor.14183