Single-centre experience with the Impella CP, in patients with cardiogenic shock

Type of funding sources: None.

Short-term percutaneous mechanical circulatory support devices are increasingly used in cardiogenic shock. The choice between Impella or extra-corporeal membrane oxygenation (ECMO) is still a matter of concern. The purpose of this work was to identify the characteristics and clinical outcomes of Impella CP in patients with cardiogenic shock in a real world setting.

A retrospective single center study was performed on all cardiogenic shock patients that were treated with Impella CP from January 01th 2020 to April 30th 2021, the primary outcome was 30-day mortality. Secondary endpoint was the occurrence of device-related complications (limb ischemia, access site-related bleeding or dissection, access site-related infection).

We identified 16 patients with cardiogenic shock who underwent placement of an Impella CP device. 8 patients (50%) underwent support in the setting of previously known chronic heart failure and acute decompensation, 5 patients (31.2%) for the assistance of a recent acute myocardial infarction, 2 (12.5%) for high-risk PCI and one case (6.25%) of hemodynamic support for an acute rejection following heart transplantation. In 10 cases (62.5%) the main indication was bridge to decision. The combination of Impella and ECMO (ECPELLA) as a unloading therapy was used in 7 patients (43.7%). The 30-day mortality was 37.5%. There were three vascular complications (18.7%) two dissections and one vascular occlusion, solved with good final results.

The application of the Impella CP is feasible in profound cardiogenic shock in multiple scenarios with an acceptable rate of complications. More data is needed to extend and standardize its use.