Micro-Axial Flow Device (Impella 5.0) Use in Refractory Cardiogenic Shock – Single Center Experience

Background:
Refractory cardiogenic shock portends > 80% mortality rate. Percutaneous mechanical circulatory support devices have been more steadily used to bridge patients with cardiogenic shock to definitive therapy. This study describes our experience at Baylor St Luke’s Medical Center – Texas Heart Institute with the use of Impella 5.0 for this indication.

Methods:
A retrospective study of all consecutive Impella 5.0 cases implanted between 8/2013 – 3/2018.

Results:
Forty-one patients received an Impella 5.0 for refractory cardiogenic shock. The mean age was 60.2±10.8 years. The cohort was 82.9% males, 51.2% Caucasian, and 56.1% ischemic cardiomyopathy. The etiology of cardiogenic shock was primarily acute on chronic decompensated systolic heart failure (80.5%). After a median of 16 days on support (range 1-82 days), 18 patients (43.9%) were successfully bridged to longer term therapy, including 12 patients who received a durable left ventricular assist device/heart transplant (Figure 1).

Conclusions:
In our single center experience, the Impella 5.0 is a viable option for temporary circulatory support in patients with refractory cardiogenic shock.