Use of the Impella microaxial flow pump in patients with chronic heart failure and ADHF significantly improved hemodynamic parameters and resulted in favorable outcomes for 51.2% of patients.
In patients with acute-on-chronic heart failure, microaxial flow pump support provided significant hemodynamic improvement and enabled survival to durable LVAD or transplantation in the majority of patients, though definitive weaning was rare.
Absolute Event Rate: 0% vs 0%
BackgroundThe mortality rate associated with acute decompensated heart failure (ADHF) is high, and prognosis depends on restoring cardiac output.Patients frequently require mechanical circulatory support (MCS).The Impella microaxial flow pump (mAFP) is a short-term MCS used to stabilize patients.We report outcomes of mAFP use in patients with pre-existing chronic heart failure who presented with ADHF. Materials and MethodsThis retrospective single-center study included all patients with a history of chronic heart failure who presented with ADHF and were managed with mAFP.Demographic characteristics, hemodynamic variables, complications and clinical outcomes were evaluated. ResultsFifty-eight patients were included.Patients were managed with the Impella 5.5/5.0 (n=52, 89.7%) or CP (n=6, 10.3%).After mAFP implantation, there was a significant reduction in vasoactive inotropic score (p<0.001),increase in glomerular filtration rate (p<0.001), and reduction in lactate levels (p<0.001).Two patients (3.4%) were lost to follow-up, 28 (51.2%) were bridged to durable left ventricular assist device (LVAD), and three (5.2%) were bridged to heart transplant.Eight patients (13.8%) were successfully weaned; 17 (29.3%)died while receiving mAFP support.Major complications included bleeding (n=23, 39.7%), local infection (n=37, 63.8%), sepsis (n=9, 15.5%), and renal dysfunction (n=34, 58.6%). ConclusionThe mAFP demonstrates favorable outcomes in patients with chronic heart failure who present with ADHF.It resulted in significant improvements in hemodynamic parameters, and most patients survived to durable LVAD or transplantation.In this heterogenous patient group, only a few survived definitive weaning from mAFP.
Gussinklo et al. (Sun,) reported a other. Use of the Impella microaxial flow pump in patients with chronic heart failure and ADHF significantly improved hemodynamic parameters and resulted in favorable outcomes for 51.2% of patients.