D-9 | Choice of temporary mechanical circulatory support in patients undergoing left ventricular assist device implantation

Use of temporary mechanical circulatory support (TCS) has become increasingly common in patients undergoing left ventricular assist device (LVAD) implantation. Limited data is available on the appropriate choice of TCS in these patients Hypothesis: We hypothesize that patients with impella have improved outcomes in comparison to intra-aortic balloon pump (IABP) in patients undergoing LVAD implantation Secondary data analysis was done using National Inpatients Sample (NIS) from 2016-2018. Patients with LVAD (02HA0QZ) were identified using ICD 10 PCS codes. They were divided into three groups namely Impella, IABP, or no support 2116 patients had LVAD implantation, 415 with IABP and 124 with Impella. In hospital mortality rate was higher in patients with impella (25.00%) compared to patients with IABP (9.64%), p <0.001. Total hospital cost, length of stay, acute coronary syndrome, GI bleed, RV failure and hypertension were also higher in patients with Impella compared to IABP,Table 1. Patients with Impella device had a higher odds ratio (OR 3.45, 95% CI 1.95-6.08, p <0.0001) for in-hospital mortality compared with IABP In-hospital mortality rates were higher in patients with Impella and could be attributed to these patients being sicker at time of LVAD implantation. It is extremely important to avoid complications associated with TCS placement in patients undergoing LVAD implantation to improve outcomes. Further pragmatic clinical trials are needed to delineate the best selection of TCS in these patients