Abstract 3050: Safety and Feasibility of Elective High-Risk Percutaneous Coronary Intervention Procedures with Left Ventricular Support of the Impella Recover LP 2.5 device
Background: Currently, the most used left ventricular support device is intra aortic balloon counter pulsation (IABP). Routine periprocedural implantation of an IABP may reduce adverse events in elective high-risk PCI. Therefore, routine periprocedural left ventricular support with a more potent left ventricular assist device may offer even more benefit and may be feasible. The percutaneous implantable Impella Recover LP 2.5 system is a novel left ventricular assist device. It basically is a microaxial rotary blood pump that expels blood from the left ventricle into the ascending aorta, thus unloading the left ventricle much like an assist device.
Methods: We studied feasibility and safety of left ventricular support with the percutaneous implantable Impella Recover LP 2.5 system in 26 consecutive high risk percutaneous coronary intervention patients.
Results: The patients were old (85% <60 years), 65% had previous myocardial infarction, 65% had a left ventricular ejection fraction ≤30% and all had left ventricular ejection fraction ≤40%. All patients were very poor candidates for surgery; Euroscores ranging from 6 to 21. Procedural success under support of the Impella device was achieved in all 26 patients. There were no procedural deaths and 2 not device related in-hospital late deaths. The median assist time was 1 hour and 43 minutes (min–max: 44min–2hr44min). Mean hemoglobin level drop was 0.8±0.4 mmol/L. The device did not induce or increase aortic valve regurgitation. There were no device related adverse events during left ventricular support with the Impella Recover LP 2.5 system.
Conclusion: These findings, concerning the safety and feasibility of the Impella recover LP 2.5 system as an assist device in elective high-risk PCI procedures are encouraging. However they must be confirmed by larger studies, longer assist times and in other patient categories.