Surgically implanted temporary ventricular assist pump - "Impella 5.5".

Abstract

The Impella 5.5 (Abiomed, Danvers, MA, USA) is an advanced left ventricular assist device that provides short-term cardiac support for patients with severe heart failure and cardiogenic shock. Its compact size and catheter-based design facilitate relatively straightforward insertion, offering mechanical support to the left ventricle without significantly increasing afterload-two key advantages. A substantial body of clinical trials and real-world evidence have confirmed its efficacy in enhancing cardiac output and organ perfusion. Notably, its short-term support has been associated with improved patient outcomes in cases of cardiogenic shock. However, the use of Impella is not without risks, including bleeding events, peripheral vascular complications, and hemolysis, underscoring the importance of appropriate patient selection, surgical planning, and meticulous post-insertion management. Future research should focus on long-term outcomes, cost-effectiveness, and continued advancements in technology. This review provides a comprehensive analysis of the Impella device, including its design, clinical applications, surgical strategies, benefits, and indications, as well as the challenges associated with its use. It reassesses its role considering the most recent evidence.