title: Preliminary experience with Impella Recover(®) LP5.0 in nine patients with cardiogenic shock: a new circulatory support system in the intensive cardiac care unit.
abstract: OBJECTIVE
  Cardiogenic shock is associated with high mortality. We report our experience with the short-term left ventricular axial pump Impella LP5.0 in nine patients with severe ischaemic heart failure.
  
  
  METHODS
  Six patients (group 1) presented with cardiogenic shock at the acute phase of an ST elevation myocardial infarction. Three patients (group 2) had severe ischaemic cardiomyopathy with temporary contra-indication to LVAD or transplantation. We measured haemodynamic and metabolic variables up to 96hours and recorded morbidity, mechanical pump failures, and mortality up to one year postimplantation.
  
  
  RESULTS
  In all patients the Impella LP5.0 was safely placed through the right subclavian artery. Cardiac power output increased from 0.64 (0.07) W to 0.94 (0.44) W and 1.02 (0.30) W at 24 and 72hours, respectively. The Impella LP5.0 remained in place for 12 (7.2) days. In group 1, five patients were in INTERMACS Profile 3 at the time of pump insertion. Three could be weaned and survived. One patient in INTERMACS Profile 1 died of intractable heart failure within hours. In group 2, two of three patients underwent heart transplantation. Haemorrhage requiring transfusions was observed in four patients but only one case was directly related to the Impella LP5.0.
  
  
  CONCLUSIONS
  Left ventricular assistance with the Impella LP5.0 appears to be well tolerated. It may be especially useful in patients with acute myocardial infarction complicated by cardiogenic shock who achieve INTERMACS Profile 3 with initial treatment.
authors.affiliation: Intensive Cardiac Care Unit, Hospices Civils de Lyon, France.
authors.forename: Didier
authors.initials: D
authors.lastname: Bresson
authors.forename: Franck
authors.initials: F
authors.lastname: Sibellas
authors.forename: Fadi
authors.initials: F
authors.lastname: Farhat
authors.forename: Olivier
authors.initials: O
authors.lastname: Jegaden
authors.forename: Gilbert
authors.initials: G
authors.lastname: Kirkorian
authors.forename: Eric
authors.initials: E
authors.lastname: Bonnefoy
mesh_terms: D000328:Adult; D000368:Aged; D003325:Coronary Care Units; D005240:Feasibility Studies; D005260:Female; D005602:France; D006353:Heart-Assist Devices / Q000009:adverse effects; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D011474:Prosthesis Design; D012189:Retrospective Studies; D012770:Shock, Cardiogenic / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left