JTCVS open · 2026
Impact of prolonged microaxial flow pump support on outcomes in heart transplantation: A single-center experience.
СтатьяНазвание и аннотация: Перевод в очереди
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Masood Muhammad F, Rahimi Mehran, Mikami Ryan, Freyaldenhoven Mary Kate, Waken R J, Fischer Irene, Braasch Maxwell, Weerasooriya Maya, Haynes Jackson, Tran Nguyen Nguyen Huyen, Kotkar Kunal, Damiano Ralph J, Kaneko Tsuyoshi, Pawale Amit
Аннотация
OBJECTIVE: To evaluate whether patients receiving prolonged Impella 5.5 support (greater than 30 days) as a bridge to heart transplantation experience comparable outcomes with those receiving shorter-term support (up to 30 days).
METHODS: Institutional data were queried between December 2020 and December 2024 for adult patients who were bridged to heart transplantation with the Impella 5.5 device. Patients were stratified into 2 cohorts on the basis of the duration of Impella support (30 days or less vs more than 30 days). Key end points including in-hospital mortality rate and Impella-related complications were compared.
RESULTS: Of 359 patients who received an Impella 5.5 at our institution, a total of 66 patients were bridged to heart transplantation, which included 45 patients receiving short-term support and 21 patients receiving prolonged support. The proportion of listed patients on short-term and prolonged Impella support who received a HeartMate 3 was 6.7% and 0%, respectively (0.546). The waitlist mortality rate for patients with short-term and prolonged Impella 5.5 support was 8.9% and 14.3%, respectively (P = .645). There was no 90-day posttransplantation mortality in both groups. The rate of Impella-related complications for patients receiving short-term and prolonged Impella 5.5 support was comparable between the 2 groups except for bleeding and ventricular tachyarrhythmia, which occurred more frequently in prolonged group (P < .05).
CONCLUSIONS: Prolonged Impella 5.5 support was associated with comparable waitlist mortality and greater device-related complications. Our data suggest that prolonged Impella 5.5 support is a viable strategy for bridge to heart transplantation.
METHODS: Institutional data were queried between December 2020 and December 2024 for adult patients who were bridged to heart transplantation with the Impella 5.5 device. Patients were stratified into 2 cohorts on the basis of the duration of Impella support (30 days or less vs more than 30 days). Key end points including in-hospital mortality rate and Impella-related complications were compared.
RESULTS: Of 359 patients who received an Impella 5.5 at our institution, a total of 66 patients were bridged to heart transplantation, which included 45 patients receiving short-term support and 21 patients receiving prolonged support. The proportion of listed patients on short-term and prolonged Impella support who received a HeartMate 3 was 6.7% and 0%, respectively (0.546). The waitlist mortality rate for patients with short-term and prolonged Impella 5.5 support was 8.9% and 14.3%, respectively (P = .645). There was no 90-day posttransplantation mortality in both groups. The rate of Impella-related complications for patients receiving short-term and prolonged Impella 5.5 support was comparable between the 2 groups except for bleeding and ventricular tachyarrhythmia, which occurred more frequently in prolonged group (P < .05).
CONCLUSIONS: Prolonged Impella 5.5 support was associated with comparable waitlist mortality and greater device-related complications. Our data suggest that prolonged Impella 5.5 support is a viable strategy for bridge to heart transplantation.