Impella LP 5.0 as bridge to long-term mechanical circulatory support

Impella LP 5.0 is a micro-axial, catheter-based left ventricle assist device (LVAD), which is inserted retrograde into the left ventricle across the aortic valve through a surgical peripheral access. Here we present our experience with this device utilization as bridge to long-term LVADs. From December 2010 to October 2011, we have implanted 14 Impella LP 5.0 (right axillary artery, n=13; femoral artery, n=1) in patients with cardiogenic shock and, among these, 4 (right axillary artery, n=4) have been implanted with a bridge-to-bridge intention. Mean age at the time of implantation was 43±17.9 (range 27-68) years and there was a prevalence of male (75%). Etiology of cardiogenic shock was: myocarditis (n=1), myocardial infarction (n=3). There was no major bleeding or infectious complications at the right axillary access. One patient required Impella replacement due to a pump stop. After a mean period of 16.2±8.9 (range 7-27) days of Impella support, patients were switched to a long-term LVAD (Jarvik 2000, n=2; HeartMate II, n=2). One patient died 70 days after implantation of the long-term LVAD due to multi-organ failure while the remaining patients are still alive after a mean period of follow-up of 62.7±29.7 (range 30-100) days. In conclusion, our experience shows that Impella LP 5.0 is a safe and valid option as bridge to long-term LVADs