Comparison of Hemodynamic and Biochemical Impact of Two Micro-Axial Ventricular Assist Devices [Impella 5.5 vs. 5.0

Abstract

PurposeDevice 1 [Impella 5.5 (Abiomed, Danvers MA, USA)] is the upgraded micro-axial, forward flow ventricular assist device (LVAD) developed for treatment of cardiogenic shock and provides a novel 6.2 L/min flow. Our institution was among the few selected for FDA pre-market use of Device 1. Here we compare 1) hemodynamic performance and 2) the subsequent impact on organ perfusion between Device 1 and the previous model: Device 2 [Impella 5.0].MethodsSingle center, retrospective analysis included all patients who underwent Device 2 (n=37) and Device 1 (n=11) implantation July 2012 - June 2020. Preimplant baseline hemodynamic and biochemical data were compared at 24 and 72 hours post-implantation and are presented as delta values in Figure 1. Population mean and median values for individual parameters, as well as the delta values for each device, are reported for hemodynamic and biochemical data, respectively. Statistical significance was assessed with a Student's T test; a p value of ≤ 0.05 conferred significance.ResultsBoth devices demonstrated improvement in measured parameters after implantation especially at 24 hours post-implantation (Figure 2). The trajectory of the measured hemodynamic data was nearly identical between both groups without any statistically significant difference.ConclusionIn our study, both groups were provided similar hemodynamic support and successfully reversed cardiogenic shock as evidenced by correction of biochemical parameters indicative of improvement in tissue perfusion. Larger studies are warranted to know more benefits of this new technology. Device 1 [Impella 5.5 (Abiomed, Danvers MA, USA)] is the upgraded micro-axial, forward flow ventricular assist device (LVAD) developed for treatment of cardiogenic shock and provides a novel 6.2 L/min flow. Our institution was among the few selected for FDA pre-market use of Device 1. Here we compare 1) hemodynamic performance and 2) the subsequent impact on organ perfusion between Device 1 and the previous model: Device 2 [Impella 5.0]. Single center, retrospective analysis included all patients who underwent Device 2 (n=37) and Device 1 (n=11) implantation July 2012 - June 2020. Preimplant baseline hemodynamic and biochemical data were compared at 24 and 72 hours post-implantation and are presented as delta values in Figure 1. Population mean and median values for individual parameters, as well as the delta values for each device, are reported for hemodynamic and biochemical data, respectively. Statistical significance was assessed with a Student's T test; a p value of ≤ 0.05 conferred significance. Both devices demonstrated improvement in measured parameters after implantation especially at 24 hours post-implantation (Figure 2). The trajectory of the measured hemodynamic data was nearly identical between both groups without any statistically significant difference. In our study, both groups were provided similar hemodynamic support and successfully reversed cardiogenic shock as evidenced by correction of biochemical parameters indicative of improvement in tissue perfusion. Larger studies are warranted to know more benefits of this new technology.