Inflow Part of Impella 5.0 or 5.5 Close to the Left Ventricular Structure Is a Risk Factor for Impella-Related Adverse Event.

Abstract

Impella-related adverse events, such as stroke, major bleeding, thromboembolic events, and hemolysis, occur in more than 30% of patients. Some studies have reported the importance of Impella positioning in preventing Impella-related adverse events. We considered that the position of the inflow part of Impella may influence the occurrence of adverse events. Impella 5.0 or 5.5 management was performed for 87 patients at Osaka University Hospital between October 2017 and November 2023. Impella-related adverse events occurred in 36 patients. The rates of freedom from Impella-related adverse events at 10, 20, and 30 days were 60, 49, and 39%, respectively. Bleeding events, stroke events, and hemolysis occurred in 20, 12, and 6 patients, respectively. The distances between the inflow part and left ventricular structure at systole and diastole in the patients with Impella-related adverse events were shorter than those in the patients without Impella-related adverse events (systole: 2 ± 2 vs. 8 ± 7 mm, p < 0.01; diastole: 4 ± 3 vs. 11 ± 7 mm, p < 0.01). A short distance between the inflow and left ventricular structure is a risk factor for Impella-related adverse events. It may be important that the inflow part of Impella 5.0 or 5.5 is not close to the left ventricular structure.