Repeat Impella 5.5 During Single Hospitalization: A Single Center Experience.

IF 2.2 3区医学 Q3 ENGINEERING, BIOMEDICAL

Artificial organs Pub Date : 2026-09-21 DOI:10.1111/aor.70249

Sarah Madira, Naman Baraya, Mehran Rahimi, Kunal Kotkar, Mary Sullivan, Irene Fischer, Kyle Stumbaugh, Bianca Jenkins, Ralph J Damiano, Tsuyoshi Kaneko, Muhammad F Masood, Amit A Pawale

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引用次数: 0

Abstract

Introduction: The Impella 5.5 device is a temporary mechanical circulatory support device widely used in patients with refractory cardiogenic shock. However, device-related or device-associated complications, as well as recurrent cardiogenic shock after device removal, may necessitate repeat implantation during the same hospitalization.

Methods: Out of 579 who underwent Impella 5.5 implantation at our institution between January 2020 and 2026, we reviewed the 14 patients who required repeated insertion during a single hospitalization. Indications for repeat implantation were categorized as device-related failure or physiologic deterioration. The primary outcome was survival to hospital discharge. Secondary outcomes included stroke, surgical-site infection, and access-site bleeding.

Results: Patients had a median age of 57 years, and 79% were male. Indications for repeat implantation were device-related failure in 57% (8/14) and physiologic deterioration in 43% (6/14). Median interval between devices was 10.5 days (IQR, 6-22). Repeat implantation was performed through the same axillary access site in 57% (8/14) and a new access site in 43% (6/14). After initial device insertion, 50% required VA-ECMO and 28%. Survival to hospital discharge was 71% (10/14); however, post-reimplantation complications were frequent, with stroke and access-site bleeding each occurring in 29% of patients and surgical-site infection in 7%. Five patients (36%) underwent durable LVAD implantation and 5 (36%) underwent heart or heart-kidney transplantation.

Conclusions: Repeat Impella 5.5 implantation during a single hospitalization was uncommon and was performed in a highly selected cohort with favorable survival outcomes, although accompanied by a substantial rate of neurological and local bleeding complications. These descriptive findings should be interpreted in the context of substantial selection bias, small sample size, and single-center experience.

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在一次住院期间重复Impella 5.5：单一中心体验。

简介：Impella 5.5装置是一种临时机械循环支持装置，广泛用于难治性心源性休克患者。然而，器械相关或器械相关并发症，以及器械取出后复发性心源性休克，可能需要在同一住院期间重复植入。方法：在2020年1月至2026年1月期间在我院接受Impella 5.5植入的579例患者中，我们回顾了14例在单次住院期间需要重复植入的患者。重复植入的适应症分为器械相关失效或生理恶化。主要终点是存活至出院。次要结局包括中风、手术部位感染和通路部位出血。结果：患者中位年龄为57岁，79%为男性。重复植入指征为57%（8/14）的器械相关失败和43%（6/14）的生理性恶化。装置之间的中位间隔为10.5天（IQR, 6-22）。57%（8/14）的患者通过同一腋窝通道进行重复种植，43%（6/14）的患者通过新通道进行重复种植。在初始装置插入后，50%和28%的患者需要VA-ECMO。生存率71% (10/14)；然而，移植后并发症很常见，29%的患者发生中风和手术部位出血，7%的患者发生手术部位感染。5名患者（36%）接受了持久的LVAD植入，5名患者（36%）接受了心脏或心肾移植。结论：在单次住院期间重复Impella 5.5植入是罕见的，并且在高度选择的队列中进行，具有良好的生存结果，尽管伴随着相当比例的神经和局部出血并发症。这些描述性发现应该在大量选择偏差、小样本量和单中心经验的背景下解释。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Artificial organs 工程技术-工程：生物医学

CiteScore

4.30

自引率

12.50%

发文量

303

审稿时长

4-8 weeks

期刊介绍： Artificial Organs is the official peer reviewed journal of The International Federation for Artificial Organs (Members of the Federation are: The American Society for Artificial Internal Organs, The European Society for Artificial Organs, and The Japanese Society for Artificial Organs), The International Faculty for Artificial Organs, the International Society for Rotary Blood Pumps, The International Society for Pediatric Mechanical Cardiopulmonary Support, and the Vienna International Workshop on Functional Electrical Stimulation. Artificial Organs publishes original research articles dealing with developments in artificial organs applications and treatment modalities and their clinical applications worldwide. Membership in the Societies listed above is not a prerequisite for publication. Articles are published without charge to the author except for color figures and excess page charges as noted.