Premium
Percutaneous Impella RP use for refractory right heart failure in adolescents and young adults—A multicenter U.S. experience
Author(s) -
Qureshi Athar M.,
Turner Mariel E.,
O'Neill William,
Denfield Susan W.,
Aghili Nima,
Badiye Amit,
Gandhi Radhakrishan,
Tehrani Behnam,
Chang George,
Oyama Jared K.,
Sinha Shashank,
Brozzi Nicolas,
Morray Brian
Publication year - 2020
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.28830
Subject(s) - impella , medicine , percutaneous , ventricular assist device , heart failure , refractory (planetary science) , surgery , cardiology , adverse effect , physics , astrobiology
Objective To assess the outcomes of the use of the percutaneous Impella RP device (Abiomed, Danvers, MA) in adolescents and young adults. Background Results of the Impella RP device have been reported in adults, but a multicenter experience in adolescents and young adults has yet to be reported. Methods Patients ≤21 years of age who underwent implantation of an Impella RP device for refractory right heart failure from June, 2016 to April, 2018 at nine U.S. Centers were included. Results A total of 12 adolescents, median age of 18 (14–21) years and median weight 74.4 (49–112.4) kg underwent Impella RP implantation (INTERMACS Profile 1 in nine and Profile 2 in three patients. The central venous pressure decreased from 20 (16–35) to 12 (7–17) mmHg, ( p = .001). One patient was concomitantly supported with an intra‐aortic balloon pump (IABP) and the rest with a percutaneous/surgically placed left ventricular assist device. There was one adverse event related to the Impella RP device (thrombosis requiring explant). The support duration was 6.5 days (4.8 hr–18.4 days) and survival to hospital discharge was 83%. At a median follow‐up of 11 months (5 days–2.5 years), 8 of 12 (67%) patients are alive. Conclusions In this multicenter experience, the Impella RP device was found to be efficacious and safe when used in adolescents and young adults. Further studies are warranted to identify suitable young/pediatric candidates for Impella RP therapy for right heart failure.