Premium
The postoperative use of Impella as a ventricular assist device in high‐risk patients undergoing coronary artery bypass surgery: A case series and comparison
Author(s) -
Sabra Michel J.,
Andrews Weston G.,
Crandall Marie L.,
Pirris John P.
Publication year - 2020
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.14367
Subject(s) - medicine , impella , ejection fraction , logistic regression , retrospective cohort study , artery , cardiology , hemodynamics , surgery , heart failure , ventricular assist device
Prophylactic placement of intra‐aortic balloon pumps (IABPs) for hemodynamic support has been used in high‐risk patients undergoing coronary artery bypass grafting (CABG) surgery. The use of the Impella CP (ICP) heart pump in high‐risk patients undergoing CABG has not been reported. In this study, we report our experience using ICP and IABP devices in high‐risk patients during the postoperative period. Methods This is a case series and retrospective comparison of ICP vs IABP at a single institution using data from 2017. Twenty‐eight patients underwent postoperative placement of either the ICP or an IABP. Nineteen patients received IABP and nine received the ICP heart pump. Patient characteristics, comorbidities, and complications were compared using bivariate analysis. Exact logistic regression was used to compare risk‐adjusted mortality. Results There were no statistically significant differences in epidemiologic characteristics, risk factors, or outcomes between both groups, except the ICP group had a lower preoperative left ventricular ejection fraction (22.5 vs 35; P = .028). Exact logistic regression analysis did not show a difference in 30‐day mortality between both groups ( P = .086). Conclusion The postoperative use of the ICP heart pump, to support high‐risk patients undergoing CABG, is a safe option. This practice has allowed us to perform CABG on sicker patients, specifically with depressed ejection fractions, with comparable results to the IABP. Further studies with larger patient populations are needed to draw definitive conclusions, but this pilot study demonstrates a possible expanded use of the Impella device.