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Updated: May 12, 2026
Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
Published on: June 12, 2021
Outcome of the impella device for acute mechanical circulatory support
Anthony Lemaire1, Mark B Anderson, Thomas Prendergast
1Department of Cardiothoracic Surgery, Robert Wood Johnson University Hospital, New Brunswick, NJ 08903, USA. Lemairan@umdnj.edu
Insights
The Impella device shows promising results for patients experiencing cardiogenic shock, a severe heart condition. This mechanical circulatory support improved survival rates and native heart function recovery in the study cohort.
Area of Science:
- Cardiology
- Mechanical Circulatory Support
- Critical Care Medicine
Background:
- Cardiogenic shock remains a significant cause of in-hospital mortality despite advances in treatment.
- Mechanical circulatory support (MCS) devices are crucial for managing cardiogenic shock.
- The Impella device is one such MCS option, but its outcomes require further evaluation.
Purpose of the Study:
- To evaluate the outcomes of Impella device use for acute mechanical circulatory support in patients with cardiogenic shock.
- To assess survival rates at 30 days, 90 days, and 1 year.
- To determine the recovery of native heart function and identify device-related complications.
Main Methods:
- A retrospective chart review was conducted on 36 consecutive patients who received an Impella device between February 2006 and December 2010.
- Data collected included patient demographics, hemodynamic parameters, operative details, and short-term and long-term outcomes.
- Primary endpoints were 30-day survival with native heart function recovery, and 90-day and 1-year survival.
Main Results:
- The study included 36 patients with a mean age of 60.3 years; 69% were male.
- Indications for Impella use included postcardiotomy shock (64%), acute myocardial infarction (28%), and others.
- 30-day survival was 72%, with 96% of survivors recovering native heart function. 90-day and 1-year survival rates were 64% and 61%, respectively.
Conclusions:
- The Impella device demonstrated a very favorable outcome in patients with cardiogenic shock.
- The device facilitated significant recovery of native heart function in survivors.
- Impella use is associated with improved survival rates in this high-risk patient population.
Objective:
The contribution of cardiogenic shock to in-hospital mortality has not decreased significantly despite prompt revascularization, advances in medical therapy, and mechanical circulatory support. For patients in cardiogenic shock, mechanical circulatory support has been provided by a variety of devices. We report the outcome of the Impella device for acute mechanical circulatory support in cardiogenic shock in a setting of a large-volume single institution. The primary end points include survival to 30 days and recovery of native heart function and survival to 90 days and 1 year. The secondary end points include device complications.
Methods:
We performed a retrospective chart review of 36 consecutive patients who underwent placement of the Impella device from February 6, 2006, to December 31, 2010. The charts were evaluated for data relative to the patients' demographics, hemodynamics, operative details, 30-day outcome including the patients' native heart function recovery, and 90-day and 1-year survival.
Results:
Thirty-six consecutive patients were included in our study. The mean ± SD age was 60.3 ± 13 years, and 69% were men. The indication for placement of the Impella device included postcardiotomy cardiogenic shock in 23 patients (64%), acute myocardial infarction complicated with cardiogenic shock in 10 patients (28%), acute decompensated ischemic cardiomyopathy in 2 patients (6%), and myocarditis with cardiogenic shock in 1 patient (3%). The mean ± SD duration of the Impella support was 4.5 ± 3.9 days (range, 1-18). The 30-day survival rate was 72% (26/36), and, of those, 96% (25/26) recovered their native heart function and one (4%) was bridged to long-term left ventricular assist device (HeartMate II; Thoratec, Inc, Pleasanton, CA USA). The 90-day and 1-year survival was 64% and 61%, respectively.
Conclusions:
The Impella devices yielded a very favorable outcome in patients with cardiogenic shock.
