title: Circulatory support using the impella device in fontan patients with systemic ventricular dysfunction: A multicenter experience.
abstract: BACKGROUND
  There are limited mechanical circulatory support options for patients with single ventricle (SV) anatomy. This is a multicenter, retrospective study of the Impella pump to support the systemic ventricle in a cohort of SV patients with Fontan circulation.
  
  
  METHODS
  Patients with SV anatomy supported with an Impella device from 2012 to 2015 were included. Demographic information, indication for support, adverse events and short-term outcome data were collected.
  
  
  RESULTS
  Ten patients were included. The median age and weight at implant was 26 years (4-38 years) and 64 kg (15-102 kg). Indications for support were systemic ventricular failure with cardiogenic shock (n = 8) or high-risk electrophysiology (EP) procedures (n = 2). The median duration of support was 49 hr (2.7-264 hr). Support was discontinued for ventricular recovery in five patients, transition to another device in two patients, completion of EP procedure in two patients and death in one patient. Survival to hospital discharge was 80%. Adverse events occurred in 4 patients. There were two cases of hemolysis, one case of increasing aortic valve insufficiency with implant and one asymptomatic access site thrombus. There were no bleeding or thromboembolic events.
  
  
  CONCLUSIONS
  Impella devices can provide temporary support for the systemic ventricle in SV patients as a bridge to recovery or additional device. Procedural survival and adverse event profiles are favorable. © 2017 Wiley Periodicals, Inc.
authors.affiliation: Division of Cardiology, Seattle Children's Hospital, Seattle, Washington.
authors.forename: Brian H
authors.initials: BH
authors.lastname: Morray
authors.affiliation: Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, Texas.
authors.forename: Vivian V
authors.initials: VV
authors.lastname: Dimas
authors.affiliation: Division of Pediatric Cardiology, University of Virginia, Charlottesville, Virginia.
authors.forename: Scott
authors.initials: S
authors.lastname: Lim
authors.affiliation: Division of Pediatric Cardiology, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: David T
authors.initials: DT
authors.lastname: Balzer
authors.affiliation: Division of Pediatric Cardiology, Department of Pediatrics, The Lillie Frank Abercrombie Section of Cardiology, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas.
authors.forename: Dhaval R
authors.initials: DR
authors.lastname: Parekh
authors.affiliation: Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Nicolas M
authors.initials: NM
authors.lastname: Van Mieghem
authors.affiliation: Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, München, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Ewert
authors.affiliation: Division of Pediatric Cardiology, Children's Healthcare of Atlanta, Emory University, Atlanta, Georgia.
authors.forename: Dennis W
authors.initials: DW
authors.lastname: Kim
authors.affiliation: Division of Pediatric Cardiology, Department of Pediatrics, The Lillie Frank Abercrombie Section of Cardiology, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas.
authors.forename: Henri
authors.initials: H
authors.lastname: Justino
authors.affiliation: Department of Cardiothoracic Surgery, Lucille Packard Children's Hospital at Stanford, Palo Alto, California.
authors.forename: Doff B
authors.initials: DB
authors.lastname: McElhinney
authors.affiliation: Division of Cardiology, Seattle Children's Hospital, Seattle, Washington.
authors.forename: Thomas K
authors.initials: TK
authors.lastname: Jones
mesh_terms: D000293:Adolescent; D000328:Adult; D002675:Child, Preschool; D018618:Echocardiography, Doppler, Color; D017548:Echocardiography, Transesophageal; D005060:Europe; D005260:Female; D018729:Fontan Procedure / Q000009:adverse effects* / Q000401:mortality; D006330:Heart Defects, Congenital / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D006353:Heart-Assist Devices; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D011474:Prosthesis Design; D020127:Recovery of Function; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States; D018487:Ventricular Dysfunction, Left / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D016277:Ventricular Function, Left; D055815:Young Adult
keywords: congenital heart disease; mechanical support; single ventricle