title: The Impella® Recover mechanical assist device in acute cardiogenic shock: a single-centre experience of 66 patients.
abstract: OBJECTIVE
  Short-term ventricular assist devices are more frequently used in patients with acute cardiogenic shock. The aim of this study was to evaluate its effect on haemodynamic parameters, as well as the short- and long-term outcome and complication rate associated with the device.
  
  
  METHODS
  All patients treated with the Impella® Recover device at our centre from 2003 to 2014 (n = 66) were included in this study, and follow-up time was 2.9 (±0.4) years. Data were obtained through patient records and the population register. Patient-related factors, preimplantation and early postimplantation haemodynamic and biochemical parameters were analysed. Characteristics of survivors and non-survivors were compared.
  
  
  RESULTS
  The device was implanted in 66 patients and 58% (38/66) were alive at 30 days post-implantation. The mean duration of support was 7.4 (±0.8) days. Mean time in the intensive care unit was 24 (±4) days. Following device implantation, patients' cardiac index improved from 2.1 l/min/m(2) (±0.20) to 3.8 l/min/m(2) (±0.20) at Day 7, mixed venous saturation increased from 56% (±2.0) to 68% (±1.2) and diuresis increased from 69 ml/h (±9) at device insertion to 105 ml/h (±19) at Day 7 on support. Central venous pressure, lactate levels and inotropic support decreased on support. No difference between survivors and non-survivors was established. No correlation was established between preimplant parameters and 30-day mortality.
  
  
  CONCLUSIONS
  The Impella® Recover device improved haemodynamics in patients with acute cardiogenic shock. Still, 30-day mortality remains high and future studies must focus on the optimal timing of placement of the device.
authors.affiliation: Department of Cardiothoracic Surgery, Uppsala University Hospital, Uppsala, Sweden.
authors.forename: Petter
authors.initials: P
authors.lastname: Schiller
authors.affiliation: Department of Cardiothoracic Surgery, Uppsala University Hospital, Uppsala, Sweden.
authors.forename: Per
authors.initials: P
authors.lastname: Vikholm
authors.affiliation: Department of Cardiothoracic Surgery, Uppsala University Hospital, Uppsala, Sweden laila.hellgren.johansson@akademiska.se.
authors.forename: Laila
authors.initials: L
authors.lastname: Hellgren
mesh_terms: D000208:Acute Disease; D005260:Female; D006353:Heart-Assist Devices; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D020127:Recovery of Function; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D012770:Shock, Cardiogenic / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D013548:Sweden; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left
keywords: Acute cardiogenic shock; Heart failure; Left ventricular assist device