A Canadian Experience With a Percutaneous Microaxial Ventricular Assist Device in Children With Cardiogenic Shock

Area of Science:

• Pediatric Cardiology
• Mechanical Circulatory Support
• Pediatric Critical Care

Background:

• Experience with percutaneous microaxial ventricular assist devices (Impella) in pediatric cardiogenic shock is limited.
• This study reviews institutional clinical outcomes of Impella use in children with cardiogenic shock.

Purpose of the Study:

• To assess the clinical outcomes of Impella device use in children experiencing cardiogenic shock.
• To evaluate the safety and efficacy of Impella for hemodynamic support and left ventricular decompression in pediatric patients.

Main Methods:

• Single-center retrospective study of pediatric patients (adult-sized) who received Impella implantation.
• Data collected included clinical outcomes, hemodynamic parameters, and device-related complications from June 2019 to December 2024.

Main Results:

• Seven pediatric patients (median age 15 years) received Impella support for a median of 5 days.
• Indications included hemodynamic support (5 patients) and left ventricular decompression during ECMO (2 patients).
• Outcomes included bridging to durable ventricular assist device (3 patients), myocardial recovery (2 patients), and complications like aortic regurgitation (1 patient).

Conclusions:

• Percutaneous microaxial pumps are increasingly utilized for pediatric cardiogenic shock and ECMO-related left ventricular decompression.
• This report contributes to the understanding of mechanical circulatory support options in Canada for critically ill children.