Impella RP for Patients with Acute Right Ventricular Failure and Cardiogenic Shock: A Subanalysis from the IMP-IT Registry
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Statistical Analysis
3. Results
3.1. Patient Population and Baseline Characteristics
3.2. Procedural Characteristics
3.3. In-Hospital Outcomes
3.4. One-Year Outcomes
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A. Description of the Impella RP Device
Appendix B. Study Endpoints and Definitions
- −
- Stroke is defined as the duration of a focal or global neurological deficit ≥24 h; or <24 h if the available neuroimaging documents a new hemorrhage or infarct or if the neurological deficit results in death.
- −
- Transient ischemic attack is defined as the duration of a focal or global neurological deficit <24 h; any variable neuroimaging does not demonstrate a new hemorrhage or infarct.
References
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Patients (n = 15) | |
---|---|
Age | 67.8 ± 14.4 |
Male | 10 (66.7) |
Hypertension | 8 (53.3) |
Dyslipidaemia | 5 (33.3) |
Diabetes mellitus | 3 (20.0) |
Chronic pulmonary disease | 4 (26.7) |
Prior myocardial infarction | 3 (20.0) |
Previous percutaneous coronary intervention | 5 (33.3) |
Previous coronary artery bypass graft | - |
Chronic kidney disease * | 4 (26.7) |
Dialysis | 2 (13.3) |
Atrial fibrillation | 4 (26.7) |
Prior transient ischaemic attack or stroke | 2 (13.3) |
Peripheral artery disease | 1 (6.7) |
Chronic heart failure | 2 (13.3) |
Left ventricular ejection fraction, % | 32.9 ± 13.7 |
Right ventricular dysfunction | 15 (100) |
Out-of-hospital cardiac arrest | 2 (13.3) |
Aetiology of cardiogenic shock | |
ST-elevation myocardial infarction | 6 (40.0) |
Acute myocarditis | 2 (13.3) |
Other | 7 (46.7) |
Haemodynamic Values | |
Heart rate, bpm | 85.9 ± 25.0 |
Mean arterial pressure, mmHg | 65.2 ± 11.2 |
Laboratory values | |
pH | 7.34 ± 0.1 |
Serum lactate, mmol/L | 5.1 ± 3.9 |
Haemoglobin, g/dL | 12.2 ± 2.0 |
Serum creatinine, mg/dL | 2.1 ± 1.2 |
Other Concomitant pVAD | Patients (n = 15) |
---|---|
Isolated Impella RP | 9 (60.0) |
Impella RP + left-side Impella (BiPELLA) | 6 (40.0) |
Impella 2.5 | 2 (13.3) |
Impella CP | 4 (26.7) |
Impella 5.0 | - |
Intra-aortic balloon pump | 7 (46.7) |
Inotropes | 7 (46.7) |
Mechanical ventilation | 13 (86.7) |
Duration of Impella support, hours | 156.0 ± 92.1 |
Length of mechanical ventilation, hours | 96 (48–252) |
Intensive care length of stay, days | 15 (10–27) |
Patients (n = 8) | |
---|---|
Coronary angiography performed | 8 (53.3) |
PCI performed | 5 (33.3) |
Left main disease | 1 (6.7) |
Left anterior descending artery disease | 3 (20.0) |
Left circumflex disease | 3 (20.0) |
Right coronary artery disease | 6 (40.0) |
Number of diseased vessels | 1.1 ± 1.2 |
Three-vessel disease | 2 (13.3) |
Patients (n = 15) | |
---|---|
Death | 7 (46.7) |
Life-threatening or severe bleeding | - |
Number of red blood cell transfusions | 8.79 ± 9.6 |
Device-related complications | |
Access-site bleeding | - |
Haemolysis | 4 (26.6) |
Limb ischaemia | 3 (20.0) |
Sepsis | 9 (60.0) |
Acute kidney injury * | 10 (66.7) |
Need for renal replacement therapy | 7 (46.7) |
Escalation therapy | 2 (13.3) |
LVEF at discharge, % | 35.8 ± 17.7 |
Patients (n = 15) | |
---|---|
All-cause death | 8 (53.33) |
Cardiac death | 8 (53.3) |
Hospitalisation for heart failure | - |
Myocardial infarction | - |
Stroke | 2 (13.3) |
LVAD or heart transplant | 1 (6.7) |
Death, hospitalization for heart failure, LVAD or heart transplant | 9 (60.0) |
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Share and Cite
Botti, G.; Gramegna, M.; Burzotta, F.; Masiero, G.; Briguori, C.; Trani, C.; Napodano, M.; Scandroglio, A.M.; Montorfano, M.; Tarantini, G.; et al. Impella RP for Patients with Acute Right Ventricular Failure and Cardiogenic Shock: A Subanalysis from the IMP-IT Registry. J. Pers. Med. 2022, 12, 1481. https://doi.org/10.3390/jpm12091481
Botti G, Gramegna M, Burzotta F, Masiero G, Briguori C, Trani C, Napodano M, Scandroglio AM, Montorfano M, Tarantini G, et al. Impella RP for Patients with Acute Right Ventricular Failure and Cardiogenic Shock: A Subanalysis from the IMP-IT Registry. Journal of Personalized Medicine. 2022; 12(9):1481. https://doi.org/10.3390/jpm12091481
Chicago/Turabian StyleBotti, Giulia, Mario Gramegna, Francesco Burzotta, Giulia Masiero, Carlo Briguori, Carlo Trani, Massimo Napodano, Anna Mara Scandroglio, Matteo Montorfano, Giuseppe Tarantini, and et al. 2022. "Impella RP for Patients with Acute Right Ventricular Failure and Cardiogenic Shock: A Subanalysis from the IMP-IT Registry" Journal of Personalized Medicine 12, no. 9: 1481. https://doi.org/10.3390/jpm12091481