Circulatory support using the impella device in fontan patients with systemic ventricular dysfunction: A multicenter...

Area of Science:

• Cardiology
• Medical Devices
• Pediatric Cardiology

Background:

• Limited mechanical circulatory support options exist for single ventricle (SV) patients.
• The Impella pump was evaluated for systemic ventricle support in SV patients with Fontan circulation.

Purpose of the Study:

• To assess the safety and efficacy of Impella pump support in single ventricle patients with Fontan circulation.

Main Methods:

• A multicenter, retrospective study included 10 SV patients with Fontan circulation supported by an Impella device between 2012 and 2015.
• Data collected included demographics, indications for support, adverse events, and short-term outcomes.

Main Results:

• The median age was 26 years; indications included systemic ventricular failure (n=8) and high-risk electrophysiology procedures (n=2).
• Median support duration was 49 hours. Survival to hospital discharge was 80%.
• Adverse events occurred in 4 patients (hemolysis, aortic valve insufficiency, access site thrombus), with no bleeding or thromboembolic events.

Conclusions:

• Impella devices provide temporary systemic ventricle support in SV patients, serving as a bridge to recovery or other devices.
• The Impella pump demonstrates favorable procedural survival and an acceptable adverse event profile in this cohort.