Abstract 18270: Interagency Registry for Mechanically Assisted Circulatory Support Profile is Associated With Outcomes in Patients With an Impella 5.5 Ventricular Assist Device

Abstract

Introduction: The Impella 5.5 left ventricular assist device (LVAD) can provide temporary mechanical circulatory support (MCS) in select patients with advanced heart failure (HF). The Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) profile provides a standardized grading system for advanced HF patients receiving MCS, ranging from most (1) to least severe (7). Hypothesis: The INTERMACS profile is associated with outcomes in patients supported with an Impella 5.5 LVAD. Methods: From 2019-2022, retrospective review of perioperative characteristics, INTERMACS profile and outcomes in patients supported with an Impella 5.5. Results: When stratified by INTERMACS profile, there were 63 patients (28%) in profile 1, 73 (32%) in profile 2, 20 (8.8%) in profile 3, 72 (32%) in profiles 4-7. Indication for Impella 5.5 implant was primarily cardiogenic shock due to chronic HF (81; 52%), acute MI (33; 21%) or postcardiotomy (22; 14%) in profiles 1-3 and Impella 5.5-assisted cardiac interventions (cardiac surgery, VT ablation, PCI) (68; 94%) in profile 4-7 (p<0.01). Composite freedom from death, durable LVAD, or heart transplant occurred for 63 (41%) profile 1-3 and 66 (92%) profile 4-7 patients (p<0.01). Conclusions: Patients with advanced INTERMACS profiles (1-3) primarily underwent Impella 5.5 implant for chronic HF, postcardiotomy, or acute MI cardiogenic shock, whereas patients in profiles 4-7 primarily underwent Impella 5.5-assisted cardiac interventions. Patients with advanced profiles were more often transitioned to durable LVAD or heart transplant, however, also had higher rates of mortality.