The Impella Recover microaxial left ventricular assist device reduces mortality for postcardiotomy failure: a three-center experience.

摘要: Abstract Background We evaluated patient outcomes and complications associated with the microaxial Impella Recover left ventricular assist device (Impella Cardiosystems AG, Aachen, Germany) for postcardiotomy low-output syndrome. This low-cost is inserted across aortic valve through a 10-mm vascular graft sewn to ascending aorta. Methods patients were compared 198 treated an intraoperative intra-aortic balloon pump between January 2000 December 2002. Three risk scores used: Hausmann score, Texas Heart Institute Cleveland intensive care unit score. Between September 2001 March 2003, 24 Before insertion, 21 could not be separated from cardiopulmonary bypass, 3 had postoperative hemodynamic instability despite high-dose catecholamines. Sixteen 8 alone (no because of peripheral disease or deemed unnecessary). Results No technical problems insertion occurred. Pump flow was 3.3 ± 0.7 L/min at 28,000 4500 RPM. Support time 61 56 hours (range, 7-228 hours). Four devices required repositioning. One failed (leaking purge line) removed. Hemolysis minimal (lactate dehydrogenase levels 540 260 U/dL survivors). Mortality 54% (13/24), similar that high-risk (Hausmann score ≥2 [57%], [51%], ≥0.75 [55%], cardiac index ≤2.3 [45%]). Cardiac output data available in 19 patients. able increase their 1 more above 10% (1/10) mortality, versus 88% (8/9) residual function less (P = .001). Comparison showed significant reduction regardless definition used. Residual strongest predictor survival Conclusions The provides 4 flow. It improves syndrome if heart