Single Center Experience With Impella 5.5 for Escalation and De-Escalation of Cardiogenic Shock Patients

Abstract

Temporary mechanical circulatory support (tMCS) devices are a critical component for treating patients with cardiogenic shock (CS). We analyzed use of Impella 5.5 device for efficacy and safety in a single-center CS population from February 2022 and April 2023. Thirty-six CS patients received Impella 5.5 support for a median duration of 16 (2, 63) days, during a median hospital stay of 40 (4, 97) days, with an overall survival (OS) of 69%. While 18 patients received Impella 5.5 only, 11 patients received Impella 5.5 as part of a de-escalation strategy, and 7 patients escalated from Impella CP only to Impella 5.5. At the time of implant, creatinine was 1.5 (0.6, 5.2) mg/dL and normalized to 1.1 (0.6, 7.7) mg/dL at discharge. In a subset of CS transfer patients (n = 12), median duration of support was 16 (1, 31) days, duration of hospital stay was 43 (8, 88) days, and OS was 67% (8/12). Collectively, these data demonstrate that Impella 5.5 support is safe and effectively improves laboratory values and survival outcomes in both transfer and in-house patients with CS.