{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T07:13:05Z","timestamp":1777878785853,"version":"3.51.4"},"reference-count":8,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T00:00:00Z","timestamp":1758844800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["World J Pediatr Congenit Heart Surg"],"published-print":{"date-parts":[[2026,3]]},"abstract":"\n \n Combining the Impella device and extracorporeal membrane oxygenation (ECMO) support has been suggested to counteract the left ventricular (LV) afterload seen with ECMO, prevent complications during venoarterial-ECMO (VA-ECMO), and facilitate weaning from VA-ECMO. While this technique has been successfully utilized in adults, there are limited efficacy data in patients under 18 years of age.<\/jats:p>\n <\/jats:sec>\n \n \n Between July 2016 and April 2024, eight pediatric patients, who were 13 to 18 years of age and weighing 40 to 59\u2005kg, underwent VA-ECMO support with Impella 2.5 or CP implantations at our institution. All patients were hemodynamically unstable at presentation (INTERMACS 1).<\/jats:p>\n <\/jats:sec>\n \n \n The indications for implantation were heart failure secondary to myocarditis (four patients), rejection of a prior orthotopic heart transplant (one patient), heart failure after repair of transposition of the great arteries (one patient), metabolic cardiomyopathy (one patient), and arrhythmia-induced cardiomyopathy (one patient). The VA-ECMO cannulation was performed via neck vessels in six patients and groin vessels in two. The median duration of Impella support was eight days (range, 2-20 days). Our practice is to wean the patient off ECMO first while ensuring support in the early stages of ECMO removal with the Impella device. The median duration of ECMO support was seven days (range, 4-32 days). One patient was bridged to transplant, one patient received a HeartMate3, five patients recovered myocardial function and were weaned off mechanical support, and one patient died while on support.<\/jats:p>\n <\/jats:sec>\n \n \n In adolescent acute heart failure, a short ECMO run with LV unloading provided by the Impella device is a promising strategy that might facilitate rapid recovery of myocardial function in hemodynamically unstable adolescents.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/21501351251369436","type":"journal-article","created":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T18:59:10Z","timestamp":1758913150000},"page":"275-278","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Left Ventricular Unloading With the Impella Pump in Adolescents on Venoarterial Extracorporeal Membrane Oxygenation"],"prefix":"10.1177","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5867-5823","authenticated-orcid":false,"given":"Matteo","family":"Trezzi","sequence":"first","affiliation":[{"name":"Bambino Ges\u00f9 Children's Hospital, IRCCS"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianluca","family":"Brancaccio","sequence":"additional","affiliation":[{"name":"Bambino Ges\u00f9 Children's Hospital, IRCCS"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marin","family":"Verrengia","sequence":"additional","affiliation":[{"name":"Bambino Ges\u00f9 Children's Hospital, IRCCS"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sergio","family":"Filippelli","sequence":"additional","affiliation":[{"name":"Bambino Ges\u00f9 Children's Hospital, IRCCS"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3787-0873","authenticated-orcid":false,"given":"Gianluigi","family":"Perri","sequence":"additional","affiliation":[{"name":"Bambino Ges\u00f9 Children's Hospital, IRCCS"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabio","family":"Miraldi","sequence":"additional","affiliation":[{"name":"Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachele","family":"Adorisio","sequence":"additional","affiliation":[{"name":"Bambino Ges\u00f9 Children's Hospital, IRCCS"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Amodeo","sequence":"additional","affiliation":[{"name":"Bambino Ges\u00f9 Children's Hospital, IRCCS"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,9,26]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/jocs.14560"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.668"},{"issue":"4","key":"e_1_3_2_4_2","first-page":"618","article-title":"Patient size parameters to guide the use of the Impella device in pediatric patients","volume":"94","author":"Morray BH","year":"2019","unstructured":"Morray BH, Dimas VV, McElhinney DB, Puri K, Qureshi AM. Patient size parameters to guide the use of the Impella device in pediatric patients. Catheter Cardiovasc Interv. 2019; 94 (4): 618- 624.","journal-title":"Catheter Cardiovasc Interv"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2022.11.039"},{"issue":"1","key":"e_1_3_2_6_2","first-page":"124","article-title":"A multicenter study of the impella device for mechanical support of the systemic circulation in pediatric and adolescent patients","volume":"90","author":"Dimas VV","year":"2017","unstructured":"Dimas VV, Morray BH, Kim DW, et al. A multicenter study of the impella device for mechanical support of the systemic circulation in pediatric and adolescent patients. Catheter Cardiovasc Interv. 2017; 90 (1): 124- 129.","journal-title":"Catheter Cardiovasc Interv"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000002150"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-021-03676-5"},{"issue":"4","key":"e_1_3_2_9_2","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1177\/02676591241268389","article-title":"Science of left ventricular unloading","volume":"40","author":"Meani P","year":"2024","unstructured":"Meani P, Todaro S, Veronese G, et al. Science of left ventricular unloading. Perfusion. 2024; 40 (4): 818- 831.","journal-title":"Perfusion"}],"container-title":["World Journal for Pediatric and Congenital Heart Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/21501351251369436","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/21501351251369436","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/21501351251369436","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T23:27:54Z","timestamp":1777591674000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/21501351251369436"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,26]]},"references-count":8,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1177\/21501351251369436"],"URL":"https:\/\/doi.org\/10.1177\/21501351251369436","relation":{},"ISSN":["2150-1351","2150-136X"],"issn-type":[{"value":"2150-1351","type":"print"},{"value":"2150-136X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,26]]}}}