Abstract：
UNASSIGNED: Impella 5.5 (Abiomed, Danvers, MA, USA) is approved by the US Food and Drug Administration (FDA) for mechanical circulatory support for ≤14 days. It is unknown whether prolonged support is associated with worse outcomes. We sought to review our single-center experience with Impella 5.5 and compare outcomes based on support duration.
UNASSIGNED: We retrospectively reviewed adult patients (≥18 years old) supported with Impella 5.5 at our institution (May 2020 to April 2023). Patients on prolonged support (>14 days) were compared with those supported for ≤14 days.
UNASSIGNED: There were 31 patients supported with Impella 5.5 including 14 (45.2%) supported >14 days. Median support duration for those on prolonged support was 43.5 (interquartile range [IQR] 25 to 63.5) days versus 8 (IQR 6, 13) days for those who were not (P < 0.001). Overall, the device-related complication rate was 9.7% and did not differ between groups (P = 0.08). Overall, 30-day postimplant survival was 71% and did not differ by support duration (P = 0.2). In-hospital mortality was 32% and did not differ between cohorts (P > 0.99). Among those surviving to explant (n = 22), long-term strategy included bridge to durable ventricular assist device (18%, n = 4), cardiac transplant (55%, n = 12), and cardiac recovery (27%, n = 6).
UNASSIGNED: High-risk patients with cardiogenic shock may be supported with Impella 5.5 beyond the FDA-approved duration without increased risk of complications or mortality.
UNASSIGNED: We retrospectively reviewed adult patients (≥18 years old) supported with Impella 5.5 at our institution (May 2020 to April 2023). Patients on prolonged support (>14 days) were compared with those supported for ≤14 days.
UNASSIGNED: There were 31 patients supported with Impella 5.5 including 14 (45.2%) supported >14 days. Median support duration for those on prolonged support was 43.5 (interquartile range [IQR] 25 to 63.5) days versus 8 (IQR 6, 13) days for those who were not (P < 0.001). Overall, the device-related complication rate was 9.7% and did not differ between groups (P = 0.08). Overall, 30-day postimplant survival was 71% and did not differ by support duration (P = 0.2). In-hospital mortality was 32% and did not differ between cohorts (P > 0.99). Among those surviving to explant (n = 22), long-term strategy included bridge to durable ventricular assist device (18%, n = 4), cardiac transplant (55%, n = 12), and cardiac recovery (27%, n = 6).
UNASSIGNED: High-risk patients with cardiogenic shock may be supported with Impella 5.5 beyond the FDA-approved duration without increased risk of complications or mortality.
摘要：
■Impella5.5（Abiomed，丹弗斯,MA,USA）经美国食品和药物管理局（FDA）批准用于≤14天的机械循环支持。目前尚不清楚长期支持是否与更糟糕的结果相关。我们试图回顾我们使用Impella5.5的单中心经验，并根据支持持续时间比较结果。
■我们回顾性审查了在我们机构（2020年5月至2023年4月）接受Impella5.5支持的成年患者（≥18岁）。将长期支持（>14天）的患者与支持≤14天的患者进行比较。
■有31例患者支持Impella5.5，包括14（45.2％）支持>14天。长期支持的患者的中位支持时间为43.5天（四分位距[IQR]25至63.5天），而非长期支持的患者为8天（IQR6,13天）（P<0.001）。总的来说,器械相关并发症发生率为9.7%,组间无差异(P=0.08).总的来说,30天的后植体存活率为71％，并且在支持持续时间上没有差异（P=0.2）。住院死亡率为32％，队列之间没有差异（P>0.99）。在那些存活到外植体(n=22)中，长期策略包括桥接耐用的心室辅助装置(18%，n=4),心脏移植（55%，n=12),和心脏恢复(27%，n=6)。
■心源性休克高危患者可以在FDA批准的持续时间后使用Impella5.5进行支持，而不会增加并发症或死亡的风险。
■我们回顾性审查了在我们机构（2020年5月至2023年4月）接受Impella5.5支持的成年患者（≥18岁）。将长期支持（>14天）的患者与支持≤14天的患者进行比较。
■有31例患者支持Impella5.5，包括14（45.2％）支持>14天。长期支持的患者的中位支持时间为43.5天（四分位距[IQR]25至63.5天），而非长期支持的患者为8天（IQR6,13天）（P<0.001）。总的来说,器械相关并发症发生率为9.7%,组间无差异(P=0.08).总的来说,30天的后植体存活率为71％，并且在支持持续时间上没有差异（P=0.2）。住院死亡率为32％，队列之间没有差异（P>0.99）。在那些存活到外植体(n=22)中，长期策略包括桥接耐用的心室辅助装置(18%，n=4),心脏移植（55%，n=12),和心脏恢复(27%，n=6)。
■心源性休克高危患者可以在FDA批准的持续时间后使用Impella5.5进行支持，而不会增加并发症或死亡的风险。
