Response by Flaherty to Letter Regarding Article, "Hemodynamic Support With a Micro-Axial Percutaneous Left Ventricular Assist Device (Impella) Protects Against Acute Kidney Injury in Patients Undergoing High-Risk Percutaneous Coronary Intervention".

Abstract

We welcome the opportunity to address the questions raised by Naranjo et al in their letter entitled Hemodynamic Support With a Micro-Axial Percutaneous Left Ventricular Assist Device (Impella) Protects Against Acute Kidney Injury in Patients Undergoing High-Risk Percutaneous Coronary Intervention. In their letter, Naranjo et al pointed out the lack of additional experimental arms in our single-center study investigating the renal protective effect of partial hemodynamic support using the microaxial percutaneous left ventricular assist device (pLVAD) Impella 2.5 during high-risk percutaneous coronary intervention. Naranjo et al would have had us include patients supported with intra-aortic balloon pumps (IABP) or other pLVADs. These authors believe that we may have observed similar outcomes with regard to renal protection by including additional pLVADs or IABPs in our analysis. With regard to the inclusion of additional pLVADs, we simply did not have these data to include in any meaningful way. About counterpulsation therapy, ours was a study that sought to determine the impact of systemic hemodynamic support on renal function. Sufficient consensus in the literature exists on the salutary effects of IABPs, among which systemic hemodynamic support is seldom included and the lack of which is often …