Advantages of bridging to durable left ventricular assist device with the Impella 5.0

The mainstay therapy for patients in critical cardiogenic shock (CS) is temporary mechanical circulatory support. Although there is a trend toward use of durable left ventricular assist devices (LVAD) in patients that are less ill, we present our experience with using the Impella 5.0 (Abiomed) to illustrate the potential benefits of supporting patients with critical CS before durable LVAD implantation. Since 2012, our use of the Impella has increased from 5 to 38 per year. Mortality is highest early after LVAD implantation, but our long-term survival is better than data reported to the INTERMACS registry. Use of an Impella 5.0 device as a bridge-to-durable LVAD in patients with critical CS may offer long-term survival benefit