Retrospective analysis of circulatory support with the Impella CP® device in patients with therapy refractory cardiogenic shock

Int J Cardiol. 2016 Sep 15:219:200-3. doi: 10.1016/j.ijcard.2016.06.023. Epub 2016 Jun 14.

Abstract

Background: In cardiogenic shock (CS) the Impella CP® device provides a fast available left ventricular circulatory support of up to 4.0L/min. However, the use of the Impella CP® device was not systematically analysed yet.

Methods: We performed a retrospective analysis of 28 consecutive patients suffering from severe therapy refractory CS treated with Impella CP®. Mortality was estimated using the SAPS II-Score. Primary outcome was 30-day survival. We compared the different aetiologies of CS and the effect of additional extracorporeal life support (ECLS).

Results: Aetiology of CS was acute coronary syndrome (ACS) in 15 patients, 9 patients received additional therapy with ECLS. SAPS II was 73±14, representing an estimated mortality of 87.1%. 18 patients deceased representing a 30-day survival of 36%. Comparing the different aetiologies, ACS-CS patients show a trend towards better survival. Additional therapy with ECLS did not change 30-day survival. In 3 cases, vascular complication needing surgical treatment occurred. All other patients showed no relevant complications except for the commonly seen haemolysis with consecutive need of transfusion.

Conclusion: Our data could demonstrate that the Impella CP® application in these severely diseased patients is feasible and safe. Compared to the estimated mortality, the 30-day survival seems to be improved.

MeSH terms

  • Adult
  • Aged
  • Cohort Studies
  • Extracorporeal Membrane Oxygenation / mortality*
  • Extracorporeal Membrane Oxygenation / trends*
  • Female
  • Heart-Assist Devices / trends*
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Shock, Cardiogenic / mortality*
  • Shock, Cardiogenic / physiopathology
  • Shock, Cardiogenic / therapy*
  • Survival Rate / trends