Retrospective analysis of circulatory support with the Impella CP® device in patients with therapy refractory cardiogenic shock.
BACKGROUND
In cardiogenic shock (CS) the Impella CP® device provides a fast available left ventricular circulatory support of up to 4.0L/min. However, the use of the Impella CP® device was not systematically analysed yet.


METHODS
We performed a retrospective analysis of 28 consecutive patients suffering from severe therapy refractory CS treated with Impella CP®. Mortality was estimated using the SAPS II-Score. Primary outcome was 30-day survival. We compared the different aetiologies of CS and the effect of additional extracorporeal life support (ECLS).


RESULTS
Aetiology of CS was acute coronary syndrome (ACS) in 15 patients, 9 patients received additional therapy with ECLS. SAPS II was 73±14, representing an estimated mortality of 87.1%. 18 patients deceased representing a 30-day survival of 36%. Comparing the different aetiologies, ACS-CS patients show a trend towards better survival. Additional therapy with ECLS did not change 30-day survival. In 3 cases, vascular complication needing surgical treatment occurred. All other patients showed no relevant complications except for the commonly seen haemolysis with consecutive need of transfusion.


CONCLUSIONS
Our data could demonstrate that the Impella CP® application in these severely diseased patients is feasible and safe. Compared to the estimated mortality, the 30-day survival seems to be improved.
Department of Cardiology, Munich University Clinic, Ludwig-Maximilians University, Munich, Germany. Electronic address: Korbinian.Lackermair@med.uni-muenchen.de.
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Lackermair
Department of Cardiology, Munich University Clinic, Ludwig-Maximilians University, Munich, Germany; Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
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Sattler
Department of Cardiology, Munich University Clinic, Ludwig-Maximilians University, Munich, Germany.
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Huber
Department of Cardiology, Munich University Clinic, Ludwig-Maximilians University, Munich, Germany; Munich Heart Alliance, Deutsches Zentrum für Herz-Kreislauf-Forschung E.V., Munich, Germany.
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Grabmaier
Department of Cardiology, Munich University Clinic, Ludwig-Maximilians University, Munich, Germany.
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Weckbach
Department of Cardiology, Munich University Clinic, Ludwig-Maximilians University, Munich, Germany; Munich Heart Alliance, Deutsches Zentrum für Herz-Kreislauf-Forschung E.V., Munich, Germany.
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Bauer
Department of Cardiology, Munich University Clinic, Ludwig-Maximilians University, Munich, Germany.
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Theiss
Department of Cardiology, Munich University Clinic, Ludwig-Maximilians University, Munich, Germany; Munich Heart Alliance, Deutsches Zentrum für Herz-Kreislauf-Forschung E.V., Munich, Germany.
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Hausleiter
Department of Cardiology, Munich University Clinic, Ludwig-Maximilians University, Munich, Germany; Munich Heart Alliance, Deutsches Zentrum für Herz-Kreislauf-Forschung E.V., Munich, Germany.
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Mehilli
Department of Cardiology, Munich University Clinic, Ludwig-Maximilians University, Munich, Germany; Munich Heart Alliance, Deutsches Zentrum für Herz-Kreislauf-Forschung E.V., Munich, Germany.
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Massberg
Department of Cardiology, Munich University Clinic, Ludwig-Maximilians University, Munich, Germany.
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Brunner
D000328:Adult; D000368:Aged; D015331:Cohort Studies; D015199:Extracorporeal Membrane Oxygenation / Q000401:mortality* / Q000639:trends*; D005260:Female; D006353:Heart-Assist Devices / Q000639:trends*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012770:Shock, Cardiogenic / Q000401:mortality* / Q000503:physiopathology / Q000628:therapy*; D015996:Survival Rate / Q000639:trends