Mechanical Circulatory Support with Impella: Principles, Evidence, and Daily Practice

The Impella (Abiomed, Danvers, MA, USA) microaxial pump is a percutaneous mechanical circulatory support (MCS) that has been shown to increase coronary perfusion, reduce myocardial oxygen demand, and improve peripheral organ perfusion. Therefore, indications for the Impella device include emergency...

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Published inJournal of clinical medicine Vol. 13; no. 16; p. 4586
Main Authors Masiero, Giulia, Arturi, Federico, Panza, Andrea, Tarantini, Giuseppe
Format Journal Article
LanguageEnglish
Published Basel MDPI AG 06.08.2024
MDPI
Subjects
Angioplasty
cardiogenic shock
Cardiovascular disease
Clinical trials
Coronary vessels
Ejection fraction
Extracorporeal membrane oxygenation
Heart surgery
Hemodynamics
high-risk percutaneous coronary intervention
Hospitals
mechanical circulatory support
Mortality
Observational studies
percutaneous left ventricular assist devices
Review
Workloads
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Summary:The Impella (Abiomed, Danvers, MA, USA) microaxial pump is a percutaneous mechanical circulatory support (MCS) that has been shown to increase coronary perfusion, reduce myocardial oxygen demand, and improve peripheral organ perfusion. Therefore, indications for the Impella device include emergency use for cardiogenic shock (CS) and pre-emptive implantation during high-risk percutaneous coronary intervention (HR-PCI). However, despite their exponential use in cardiovascular practice over the past decade, there is limited randomized evidence to support the benefits of this therapy and growing concern regarding complication rates. In this review, we summarize the principles, evidence, and practical considerations of the most widely used Impella CP percutaneous left ventricular support in both CS and HR-PCI settings, moving from the historical background to current issues and future expectations for this device.
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ISSN:2077-0383
2077-0383
DOI:10.3390/jcm13164586