Author + information
- Received October 21, 2008
- Accepted November 9, 2008
- Published online February 1, 2009.
- Simon R. Dixon, MB ChB⁎,
- José P.S. Henriques, MD, PhD†,
- Laura Mauri, MD, MSc‡,
- Krischan Sjauw, MD†,
- Andrew Civitello, MD§,
- Biswajit Kar, MD§,
- Pranav Loyalka, MD§,
- Frederic S. Resnic, MD‡,
- Paul Teirstein, MD∥,
- Raj Makkar, MD¶,
- Igor F. Palacios, MD#,
- Michael Collins, MD⁎⁎,
- Jeffrey Moses, MD⁎⁎,
- Karim Benali, MD, MSc†† and
- William W. O'Neill, MD‡‡,⁎ ()
- ↵⁎Reprint requests and correspondence:
Dr. William W. O'Neill, Leonard M. Miller School of Medicine, University of Miami, P.O. Box 016099 (R.699), Miami, Florida 33101
Objectives We sought to evaluate the safety and feasibility of the Impella 2.5 system (Abiomed Inc., Danvers, Massachusetts) in patients undergoing high-risk percutaneous coronary intervention (PCI).
Background The Impella 2.5 is a miniaturized percutaneous cardiac assist device, which provides up to 2.5 l/min forward flow from the left ventricle into the systemic circulation.
Methods In a prospective, multicenter study, 20 patients underwent high-risk PCI with minimally invasive circulatory support employing the Impella 2.5 system. All patients had poor left ventricular function (ejection fraction ≤35%) and underwent PCI on an unprotected left main coronary artery or last patent coronary conduit. Patients with recent ST-segment elevation myocardial infarction or cardiogenic shock were excluded. The primary safety end point was the incidence of major adverse cardiac events at 30 days. The primary efficacy end point was freedom from hemodynamic compromise during PCI (defined as a decrease in mean arterial pressure below 60 mm Hg for >10 min).
Results The Impella 2.5 device was implanted successfully in all patients. The mean duration of circulatory support was 1.7 ± 0.6 h (range: 0.4 to 2.5 h). Mean pump flow during PCI was 2.2 ± 0.3 l/min. At 30 days, the incidence of major adverse cardiac events was 20% (2 patients had a periprocedural myocardial infarction; 2 patients died at days 12 and 14). There was no evidence of aortic valve injury, cardiac perforation, or limb ischemia. Two patients (10%) developed mild, transient hemolysis without clinical sequelae. None of the patients developed hemodynamic compromise during PCI.
Conclusions The Impella 2.5 system is safe, easy to implant, and provides excellent hemodynamic support during high-risk PCI. (The PROTECT I Trial; NCT00534859)
Supported by a grant from Abiomed Inc., Danvers, Massachusetts. Dr. Benali is a paid employee of Abiomed Inc.
Presented in part at Transcatheter Cardiovascular Therapeutics 2007, Washington, DC.
- Received October 21, 2008.
- Accepted November 9, 2008.
- American College of Cardiology Foundation