0008: Cardiogenic shock and Impella 5.0

Abstract

Cardiogenic shock is associated with a high mortality rate. Mechanical circulatory supports have been developed for refractory cardiogenic shock. The Impella 5.0 device is a rotary microaxial pump mounted on a catheter across the aortic valve, minimally invasively placed, designed for short-term circulatory support, and providing left ventricular unloading. All patients admitted in our cardiac intensive care for acute refractory cardiogenic shock and treated with Impella 5.0 between January 2010 and January 2015 were included. 12 patients were enrolled. The causes of cardiogenic shock and indications for using Impella device were acute myocardial infarction for 6 (50%), decompensated dilated cardiomyopathy for 4 (34%), myocarditis for 1 (8%) and cardiac surgery for 1 (8%). The mean duration of support was 13±8 days. The 30-days and 1-year survival was respectively 75% and 58%. Among 30-days survivors, ventricular function recovered in 5 (56%), 3 (33%) underwent heart transplant and 1 (11%) underwent implantation of a Heartmate II. Our outcomes demonstrate that the use of the Impella 5.0 strongly improved survival at 6 months. Myocardial recovery was achieved in most patients. The Impella also allowed safe implantation of long-term assistance and successful heart transplantation. Abstract 0008 – Table IMPELLA 5.0 Left ventricular ejection function (%) 21±6 Right ventricular dysfunction n (%) 0 (0) Cardiac index (L/min/m 2 ) 1.3±0.2 Mean arterial pressure (mmHg) 66±9 Systolic blood pressure (mmHg) 89±13 Lactates (mmol/L) 6.5±5 Duration of support (days) 14±8 Duration of hospitalisation in intensive care (days) 39±15 30-days survival n (%) 8 (73) 6-months survival n (%) 7 (64) 1-month LEVF (%) 45±9 Myocardial recovery n (%) 4 (63) Heart transplant (n (%) 3 (11) LVAD (Heartmate 2) n (%) 1 (9)