Safety and feasibility of elective high-risk percutaneous coronary intervention procedures with left ventricular support of the Impella Recover LP 2.5.
Currently, the most used left ventricular (LV) support device is intra-aortic balloon counterpulsation. The percutaneous implantable Impella Recover LP 2.5 system is a novel LV (unloading) assist device. We studied the feasibility and safety of LV support with the percutaneous implantable Impella Recover LP 2.5 system in 19 consecutive high-risk patients with percutaneous coronary intervention. Procedural success using the device and percutaneous coronary intervention was achieved in all 19 patients, who were very poor candidates for surgery. The patients were elderly (84% were >60 years of age), 74% had previous myocardial infarction, 63% had LV ejection fractions of < or =25%, and all had LV ejection fractions of < or =40%. There were no procedural deaths and 2 device-unrelated in-hospital late deaths. Mean decrease in hemoglobin level was 0.7 +/- 0.4 mmol/L. The device did not induce or increase aortic valve regurgitation. There were no important device-related adverse events during LV support with the Impella Recover LP 2.5 system. However, these encouraging findings must be confirmed by larger studies, longer assist times, and in other patient categories.
Henriques
José P S
JP
Department of Cardiology, Academic Medical Centre, Amsterdam, The Netherlands. j.p.henriques@amc.uva.nl
Remmelink
Maurice
M
Baan
Jan
J
van der Schaaf
René J
RJ
Vis
Marije M
MM
Koch
Karel T
KT
Scholten
Evert W
EW
de Mol
Bas A J M
BA
Tijssen
Jan G P
JG
Piek
Jan J
JJ
de Winter
Robbert J
RJ
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation*; D003327:Coronary Disease / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D004867:Equipment Design; D005240:Feasibility Studies; D006353:Heart-Assist Devices; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D008875:Middle Aged; D013318:Stroke Volume / Q000502:physiology; D016896:Treatment Outcome
D006454:Hemoglobins