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Patient size parameters to guide use of the Impella device in pediatric patients

Brian H Morray1, V Vivian Dimas2, Doff B McElhinney3

  • 1Division of Pediatric Cardiology, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Washington.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|August 20, 2019
PubMed

Insights

This study establishes size guidelines for using Impella devices in small pediatric patients needing mechanical circulatory support (MCS). Key measurements ensure proper device function in children weighing as little as 23 kg.

Area of Science:

  • Pediatric Cardiology
  • Medical Device Engineering
  • Cardiovascular Imaging

Background:

  • Limited mechanical circulatory support (MCS) options exist for pediatric patients.
  • No established data on minimum patient size for Impella 2.5 device implantation.

Purpose of the Study:

  • Define patient and ventricular size parameters for Impella device placement in small pediatric patients (10-30 kg).
  • Guide healthcare providers in selecting appropriate pediatric candidates for Impella MCS.

Main Methods:

  • Multicenter study utilizing echocardiography and MRI data.
  • Measured left ventricular (LV) length and ascending aorta dimensions.
  • Determined minimum size parameters for Impella catheter placement.

Main Results:

  • Impella 2.5 requires an LV apical length of 7.5 cm for unconstrained function.
  • This corresponds to a minimum height of 121-122 cm and weight of 23-23.9 kg.
  • Body surface area (BSA) of 0.89 m² was associated with these dimensions.

Conclusions:

  • Mechanical circulatory support (MCS) with Impella devices is feasible in pediatric populations.
  • This study provides crucial anthropomorphic and anatomic measurements for guiding Impella device selection in children.
Abstract

Keywords:
congenital heart diseasemechanical supportpediatrics

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