Using the Impella 5.0 with a right axillary artery approach as bridge to long-term mechanical circulatory assistance
| Autor: | Anthony Nguyen, Ciro Mastroianni, Alain Pavie, Pascal Leprince, Matteo Pozzi, M. Niculescu, Astrid Quessard |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2013 |
| Předmět: |
Adult
Male Aortic valve medicine.medical_specialty Myocardial Infarction Shock Cardiogenic Biomedical Engineering Medicine (miscellaneous) Bioengineering Biomaterials Axillary artery Internal medicine medicine.artery medicine Humans Myocardial infarction Heart-Assist Devices Cardiogenic shock Impella Aged Retrospective Studies Assisted circulation Left ventricular dysfunction Ventricle-assist device business.industry General Medicine Middle Aged medicine.disease Treatment Outcome medicine.anatomical_structure Ventricle Circulatory system Cardiology Axillary Artery Female business |
| Popis: | Purpose Impella 5.0 is a short-term left ventricle assist device (LVAD), inserted retrograde into the left ventricle across the aortic valve through a surgical peripheral access. Impella has been utilized for various indications but in the setting of bridge-to-bridge application there are limited reports. Methods We performed a retrospective observational analysis of Impella utilization at our institution as bridge to long-term LVADs. The primary end-point was survival during Impella support. Results Between December 2010 and February 2012, we implanted 20 Impella in patients with cardiogenic shock and, among these, 5 were implanted as bridge to long-term LVADs. In this latter group, mean age at the time of implantation was 44 ∓ 15.6 (range 27-68) years and there was a prevalence of males (80%). Etiology of cardiogenic shock was: decompensated anthracycline-induced cardiomyopathy (n = 1), myocardial infarction (n = 4). There was no major bleeding requiring surgical revision or infectious complications at the right axillary access. One patient required Impella replacement due to a pump stop. After a mean period of 14.2 ∓ 9.0 (range 6-27) days of Impella support, patients were switched to a long-term LVAD (Jarvik 2000, n = 2; HeartMate II, n = 3). One patient died 70 days after implantation of the long-term LVAD due to multi-organ failure, while the remaining patients are still alive after a mean period of follow-up of 108.6 ∓ 66.2 (range 19-191) days. Conclusions Our experience shows that an Impella 5.0 implanted through the right axillary artery approach is a valid option as bridge to long-term LVADs. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|