Increased Incidence of De Novo Aortic Incompetence in Patients Supported with Impella Prior to LVAD Implantation

摘要: Purpose Impella (Abiomed Inc, Danvers, MA) is a temporary mechanical support device being more frequently used in INTERMACS 1 patients bridged to LVAD implantation. The percutaneously inserted across the aortic valve, and although case reports describe development of incompetence (AI) after its use, there no data on incidence AI with as bridge Methods We reviewed all undergoing primary implantation at large academic center from January 2015 onwards, identified those classified 1. then divided them by method pre-implantation support, comparing supported either VA ECMO or IABP. transthoracic echocardiography preoperatively, well week, 1, 3, 6, 9 12 months post-LVAD Patients concomitant Aortic Valve Replacement were excluded. Results A total 155 reviewed, which 45 179 echoes analysed. Twelve prior implant - six alone (5 CP, 5) conjunction (3 2.5, 2 CP 5). One died within three days was excluded analysis. Post implant, mild moderate developed 82% (9 11) compared 43% without (13 30) [p = 0.038]. There difference severity based type used. Conclusion In our cohort, durable have higher risk developing AI. Further studies are needed identify factors develop strategies mitigate this use becomes widespread.