Multi-Institutional Outcomes of Impella Use in Pediatric Patients: A Brief Communication from the ACTION Network.

This retrospective cohort study includes 150 pediatric patients supported with the Impella between 4/2018-11/2024. Median weight was 62.9kg (IQR 51.0-79.7kg) and the smallest weighed 19.0kg. Axillary artery implants occurred in 40.1% of patients while the femoral artery was used in 29%. Most patients had dilated cardiomyopathy (57.3%), however, a significant portion had transplant graft dysfunction (14.7%) or congenital heart disease (13.3%). One quarter of the cohort (N=38) were supported with ECMO prior to Impella; 76% (N=29) used ECMO and Impella in tandem, while 24% (N=9) transitioned from ECMO to Impella. Major bleeding, major infection, device malfunction, or stroke were reported in 28% of patients (N=42). Positive clinical outcomes were achieved in 89.3% of patients; 32.7% explanted for recovery, 32% transplanted, and 23.3% changed to another device. These data demonstrate a potential role for this device in children with refractory advanced heart failure, and a need for increased work to limit adverse events.