Evolution of Concomitant Use of Veno-Arterial Extracorporeal Membrane Oxygenation Support With Impella in Cardiogenic Shock: From Percutaneous Femoral Impella to Axillary Impella 5.5
Student, Resident/Fellow, Faculty
BACKGROUND: Little is known about safety and efficacy of the use of Impella 5.5 compared to previous iterations in the setting of Impella with Veno-Arterial Extracorporeal Membrane Oxygenation Support as ECPELLA. METHODS: Consecutive patients who were treated by ECPELLA with surgically implanted axillary Impella 5.5 (N = 13) were compared with patients supported by ECPELLA with percutaneous femoral Impella CP or 2.5 (Control, N = 13). RESULTS: The total ECPELLA flow was higher in ECPELLA 5.5 group (6.9 vs. 5.4 L/min, p = 0.019). Actual hospital survival was higher than predicted and comparable in both groups (ECPELLA 5.5, 61.5% vs. Control, 53.8%, p = 0.691). Both total device complications (ECPELLA 5.5, 7.7% vs. Control, 46.1%, p = 0.021) and Impella-specific complications (ECPELLA 5.5, 0% vs. Control, 30.8%, p = 0.012) were significantly lower in the ECPELLA 5.5 group. CONCLUSIONS: Utilization of Impella 5.5 in the setting of ECPELLA provides greater hemodynamic support with a lower risk of complications compared to Impella CP or 2.5.
Isath, A., Ohira, S., Levine, A., Lanier, G. M., Pan, S., Aggarwal-Gupta, C., Mason, I., Gregory, V., Spielvogel, D., Gass, A. L., & Kai, M. (2023). Evolution of Concomitant Use of Veno-Arterial Extracorporeal Membrane Oxygenation Support With Impella in Cardiogenic Shock: From Percutaneous Femoral Impella to Axillary Impella 5.5. https://doi.org/10.1111/aor.14594