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

• Published in: Artificial organs Vol. 47; no. 8; pp. 1404 - 1412
• Main Authors: Isath, Ameesh, Ohira, Suguru, Levine, Avi, Lanier, Gregg M, Pan, Stephen, Aggarwal-Gupta, Chhaya, Mason, Ian, Gregory, Vasiliki, Spielvogel, David, Gass, Alan L, Kai, Masashi
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.08.2023
• Subjects: Complications; Extracorporeal membrane oxygenation; Femur; Hemodynamics; Membranes; Oxygenation; ECMO; Impella; cardiogenic shock; ECPELLA
• ISSN: 0160-564X; 1525-1594
• DOI: 10.1111/aor.14594

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. 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). 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. 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.