{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T19:25:17Z","timestamp":1762543517244,"version":"3.28.0"},"reference-count":25,"publisher":"Texas Heart Institute Journal","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021]]},"abstract":"<jats:p>We studied whether sustained hemodynamic support (&gt;7 d) with the Impella 5.0 heart pump can be used as a bridge to clinical decisions in patients who present with cardiogenic shock, and whether such support can improve their outcomes.<\/jats:p>\n        <jats:p>We retrospectively reviewed cases of patients who had Impella 5.0 support at our hospital from August 2017 through May 2019. Thirty-four patients (23 with cardiogenic shock and 11 with severely decompensated heart failure) underwent sustained support for a mean duration of 11.7 \u00b1 9.3 days (range, \u226448 d). Of 29 patients (85.3%) who survived to next therapy, 15 were weaned from the Impella, 8 underwent durable left ventricular assist device placement, 4 were escalated to venoarterial extracorporeal membrane oxygenation support, and 2 underwent heart transplantation. The 30-day survival rate was 76.5% (26 of 34 patients). Only 2 patients had a major adverse event: one each had an ischemic stroke and flail mitral leaflet. None of the devices malfunctioned.<\/jats:p>\n        <jats:p>Sustained hemodynamic support with the Impella 5.0 not only improved outcomes in patients who presented with cardiogenic shock, but also provided time for multidisciplinary evaluation of potential cardiac recovery, or the need for durable left ventricular assist device implantation or heart transplantation. Our study shows the value of using the Impella 5.0 as a bridge to clinical decisions.<\/jats:p>","DOI":"10.14503\/thij-20-7260","type":"journal-article","created":{"date-parts":[[2021,8,13]],"date-time":"2021-08-13T18:27:14Z","timestamp":1628879234000},"source":"Crossref","is-referenced-by-count":7,"title":["Sustained Use of the Impella 5.0 Heart Pump Enables Bridge to Clinical Decisions in 34 Patients"],"prefix":"10.14503","volume":"48","author":[{"given":"Daniel W.","family":"Nelson","sequence":"first","affiliation":[{"name":"Division of Internal Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sakthi","family":"Sundararajan","sequence":"additional","affiliation":[{"name":"Division of Internal Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evan","family":"Klein","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Medical College of Wisconsin, Milwaukee, Wisconsin"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lyle D.","family":"Joyce","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Cardiothoracic Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucian A.","family":"Durham","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Cardiothoracic Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David L.","family":"Joyce","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Cardiothoracic Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Asim A.","family":"Mohammed","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Medical College of Wisconsin, Milwaukee, Wisconsin"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"5628","reference":[{"issue":"25","key":"i1526-6702-48-3-e207260-b1","series-title":"N Engl J Med","first-page":"2419","article-title":"PCI strategies in patients with acute myocardial infarction and cardiogenic shock","volume":"377","year":"2017","unstructured":"Thiele\n              H,\n            \n            \n              Akin\n              I,\n            \n            \n              Sandri\n              M,\n            \n            \n              Fuernau\n              G,\n            \n            \n              de Waha\n              S,\n            \n            \n              Meyer-Saraei\n              R,\n            \n          \n          .\n\t\t\t\t\tPCI strategies in patients with acute myocardial infarction and cardiogenic shock.\n\t\t\t\t\tN Engl J Med2017;377(25):2419\u201332."},{"issue":"20","key":"i1526-6702-48-3-e207260-b2","series-title":"Eur Heart J","first-page":"2535","article-title":"Improved outcome of cardiogenic shock at the acute stage of myocardial infarction: a report from the USIK 1995, USIC 2000, and FAST-MI French nationwide registries","volume":"33","year":"2012","unstructured":"Aissaoui\n              N,\n            \n            \n              Puymirat\n              E,\n            \n            \n              Tabone\n              X,\n            \n            \n              Charbonnier\n              B,\n            \n            \n              Schiele\n              F,\n            \n            \n              Lefevre\n              T,\n            \n          \n          .\n\t\t\t\t\tImproved outcome of cardiogenic shock at the acute stage of myocardial infarction: a report from the USIK 1995, USIC 2000, and FAST-MI French nationwide registries.\n\t\t\t\t\tEur Heart J2012;33(20):2535\u201343."},{"issue":"14","key":"i1526-6702-48-3-e207260-b3","series-title":"N Engl J Med","first-page":"1287","article-title":"Intraaortic balloon support for myocardial infarction with cardiogenic shock","volume":"367","year":"2012","unstructured":"Thiele\n              H,\n            \n            \n              Zeymer\n              U,\n            \n            \n              Neumann\n              FJ,\n            \n            \n              Ferenc\n              M,\n            \n            \n              Olbrich\n              HG,\n            \n            \n              Hausleiter\n              J,\n            \n          \n          .\n\t\t\t\t\tIntraaortic balloon support for myocardial infarction with cardiogenic shock.\n\t\t\t\t\tN Engl J Med2012;367(14):1287\u201396."},{"issue":"18","key":"i1526-6702-48-3-e207260-b4","series-title":"N Engl J Med","first-page":"1699","article-title":"One-year outcomes after PCI strategies in cardiogenic shock","volume":"379","year":"2018","unstructured":"Thiele\n              H,\n            \n            \n       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    \n              Ferenc\n              M,\n            \n            \n              Olbrich\n              HG,\n            \n            \n              Hausleiter\n              J,\n            \n          \n          .\n\t\t\t\t\tIntra-aortic balloon counterpulsation in acute myocardial infarction complicated by cardiogenic shock (IABP-SHOCK II): final 12 month results of a randomised, open-label trial.\n\t\t\t\t\tLancet2013;382(9905):1638\u201345."},{"issue":"3","key":"i1526-6702-48-3-e207260-b6","series-title":"Am Heart J","first-page":"469.e1-8","article-title":"A randomized multicenter clinical study to evaluate the safety and efficacy of the TandemHeart percutaneous ventricular assist device versus conventional therapy with intraaortic balloon pumping for treatment of cardiogenic shock","volume":"152","year":"2006","unstructured":"Burkhoff\n              D,\n            \n            \n              Cohen\n              H,\n            \n            \n              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    \n              Diederich\n              KW,\n            \n            \n              Hambrecht\n              R,\n            \n            \n              Niebauer\n              J,\n            \n            \n              Schuler\n              G.\n            \n          \n          Randomized comparison of intra-aortic balloon support with a percutaneous left ventricular assist device in patients with revascularized acute myocardial infarction complicated by cardiogenic shock.\n\t\t\t\t\tEur Heart J2005;26(13):1276\u201383."},{"issue":"19","key":"i1526-6702-48-3-e207260-b8","series-title":"J Am Coll Cardiol","first-page":"1584","article-title":"A randomized clinical trial to evaluate the safety and efficacy of a percutaneous left ventricular assist device versus intra-aortic balloon pumping for treatment of cardiogenic shock caused by myocardial infarction","volume":"52","year":"2008","unstructured":"Seyfarth\n              M,\n            \n            \n              Sibbing\n              D,\n            \n            \n              Bauer\n              I,\n            \n            \n              Frohlich\n              G,\n            \n            \n              Bott-Flugel\n              L,\n            \n            \n              Byrne\n              R,\n            \n          \n          .\n\t\t\t\t\tA randomized clinical trial to evaluate the safety and efficacy of a percutaneous left ventricular assist device versus intra-aortic balloon pumping for treatment of cardiogenic shock caused by myocardial infarction.\n\t\t\t\t\tJ Am Coll Cardiol2008;52(19):1584\u20138."},{"issue":"3","key":"i1526-6702-48-3-e207260-b9","series-title":"J Am Coll Cardiol","first-page":"278","article-title":"Percutaneous mechanical circulatory support versus intra-aortic balloon pump in cardiogenic shock after acute myocardial infarction","volume":"69","year":"2017","unstructured":"Ouweneel\n              DM,\n            \n            \n              Eriksen\n              E,\n            \n            \n              Sjauw\n              KD,\n            \n            \n              van Dongen\n              IM,\n            \n            \n              Hirsch\n              A,\n            \n            \n              Packer\n              EJS,\n            \n          \n          .\n\t\t\t\t\tPercutaneous mechanical circulatory support versus intra-aortic balloon pump in cardiogenic shock after acute myocardial infarction.\n\t\t\t\t\tJ Am Coll Cardiol2017;69(3):278\u201387."},{"issue":"17","key":"i1526-6702-48-3-e207260-b10","series-title":"Eur Heart J","first-page":"2102","article-title":"Percutaneous left ventricular assist devices vs intra-aortic balloon pump counterpulsation for treatment of cardiogenic shock: a meta-analysis of controlled trials","volume":"30","year":"2009","unstructured":"Cheng\n              JM,\n            \n            \n              den Uil\n              CA,\n            \n            \n              Hoeks\n              SE,\n            \n            \n              van der Ent\n              M,\n            \n            \n              Jewbali\n              LSD,\n            \n            \n              van Domburg\n              RT,\n            \n            \n              Serruys\n              PW.\n            \n          \n          Percutaneous left ventricular assist devices vs intra-aortic balloon pump counterpulsation for treatment of cardiogenic shock: a meta-analysis of controlled trials.\n\t\t\t\t\tEur Heart J2009;30(17):2102\u20138."},{"issue":"47","key":"i1526-6702-48-3-e207260-b11","series-title":"Eur Heart J","first-page":"3523","article-title":"Percutaneous short-term active mechanical support devices in cardiogenic shock: a systematic review and collaborative meta-analysis of randomized trials","volume":"38","year":"2017","unstructured":"Thiele\n              H,\n            \n            \n              Jobs\n              A,\n            \n            \n              Ouweneel\n              DM,\n            \n            \n              Henriques\n              JPS,\n            \n            \n              Seyfarth\n              M,\n            \n            \n              Desch\n              S,\n            \n          \n          .\n\t\t\t\t\tPercutaneous short-term active mechanical support devices in cardiogenic shock: a systematic review and collaborative meta-analysis of randomized trials.\n\t\t\t\t\tEur Heart J2017;38(47):3523\u201331."},{"issue":"3","key":"i1526-6702-48-3-e207260-b12","series-title":"Intensive Care Med","first-page":"370","article-title":"The ENCOURAGE mortality risk score and analysis of long-term outcomes after VA-ECMO for acute myocardial infarction with cardiogenic shock","volume":"42","year":"2016","unstructured":"Muller\n              G,\n            \n            \n              Flecher\n              E,\n            \n            \n              Lebreton\n              G,\n            \n         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Trouillet\n              JL,\n            \n            \n              Leger\n              P,\n            \n          \n          .\n\t\t\t\t\tOutcomes and long-term quality-of-life of patients supported by extracorporeal membrane oxygenation for refractory cardiogenic shock.\n\t\t\t\t\tCrit Care Med2008;36(5):1404\u201311."},{"issue":"1","key":"i1526-6702-48-3-e207260-b14","series-title":"BMC Emerg Med","first-page":"20","article-title":"ECMO use and mortality in adult patients with cardiogenic shock: a retrospective observational study in U.S. hospitals","volume":"18","year":"2018","unstructured":"El Sibai\n              R,\n            \n            \n              Bachir\n              R,\n            \n            \n              El Sayed\n              M.\n            \n          \n          ECMO use and mortality in adult patients with cardiogenic shock: a retrospective observational study in U.S. hospitals.\n\t\t\t\t\tBMC Emerg Med2018;18(1):20."},{"issue":"1","key":"i1526-6702-48-3-e207260-b15","series-title":"ASAIO J","first-page":"60","article-title":"Extracorporeal Life Support Organization Registry international report 2016","volume":"63","year":"2017","unstructured":"Thiagarajan\n              RR,\n            \n            \n              Barbaro\n              RP,\n            \n            \n              Rycus\n              PT,\n            \n            \n              McMullan\n              DM,\n            \n            \n              Conrad\n              SA,\n            \n            \n              Fortenberry\n              JD,\n            \n          \n          .\n\t\t\t\t\tExtracorporeal Life Support Organization Registry international report 2016.\n\t\t\t\t\tASAIO J2017;63(1):60\u20137."},{"issue":"2","key":"i1526-6702-48-3-e207260-b16","series-title":"J Thorac Cardiovasc Surg","first-page":"548","article-title":"The RECOVER I: a multicenter prospective study of Impella 5.0\/LD for postcardiotomy circulatory support","volume":"145","year":"2013","unstructured":"Griffith\n              BP,\n            \n            \n              Anderson\n              MB,\n            \n            \n              Samuels\n              LE,\n            \n            \n              Pae\n              WE\n              Jr,\n            \n            \n              Naka\n              Y,\n            \n            \n              Frazier\n              OH.\n            \n          \n          The RECOVER I: a multicenter prospective study of Impella 5.0\/LD for postcardiotomy circulatory support.\n\t\t\t\t\tJ Thorac Cardiovasc Surg2013;145(2):548\u201354."},{"issue":"10","key":"i1526-6702-48-3-e207260-b17","series-title":"Am J Cardiol","first-page":"1622","article-title":"Effectiveness and safety of the Impella 5.0 as a bridge to cardiac transplantation or durable left ventricular assist device","volume":"117","year":"2016","unstructured":"Lima\n              B,\n            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\n              Esposito\n              M,\n            \n          \n          .\n\t\t\t\t\tUse of a percutaneous temporary circulatory support device as a bridge to decision during acute decompensation of advanced heart failure.\n\t\t\t\t\tJ Heart Lung Transplant2018;37(1):100\u20136."},{"issue":"3","key":"i1526-6702-48-3-e207260-b20","series-title":"Ochsner J","first-page":"210","article-title":"Using the minimally invasive Impella 5.0 via the right subclavian artery cutdown for acute on chronic decompensated heart failure as a bridge to decision","volume":"16","year":"2016","unstructured":"Bansal\n              A,\n            \n            \n              Bhama\n              JK,\n            \n            \n              Patel\n              R,\n            \n            \n              Desai\n              S,\n            \n            \n              Mandras\n              SA,\n            \n            \n              Patel\n              H,\n            \n          \n          .\n\t\t\t\t\tUsing the minimally invasive Impella 5.0 via the right subclavian artery cutdown for acute on chronic decompensated heart failure as a bridge to decision.\n\t\t\t\t\tOchsner J2016;16(3):210\u20136."},{"issue":"7","key":"i1526-6702-48-3-e207260-b21","series-title":"ASAIO J","first-page":"642","article-title":"Clinical outcomes of Impella microaxial devices used to salvage cardiogenic shock as a bridge to durable circulatory support or cardiac transplantation","volume":"65","year":"2019","unstructured":"Cheng\n              R,\n            \n            \n              Tank\n              R,\n            \n            \n              Ramzy\n              D,\n            \n            \n              Azarbal\n              B,\n            \n            \n              Chung\n              J,\n            \n            \n              Esmailian\n              F,\n            \n          \n          .\n\t\t\t\t\tClinical outcomes of Impella microaxial devices used to salvage cardiogenic shock as a bridge to durable circulatory support or cardiac transplantation.\n\t\t\t\t\tASAIO J2019;65(7):642\u20138."},{"key":"i1526-6702-48-3-e207260-b22","unstructured":"Abiomed, Inc.\n          \n          Impella ventricular support systems for use during cardiogenic shock and high-risk PCI: instructions for use and clinical reference manual 2018.\n\t\t\t\t\tAvailable from: https:\/\/www.accessdata.fda.gov\/cdrh_docs\/pdf14\/P140003S018D.pdf","article-title":"Impella ventricular support systems for use during cardiogenic shock and high-risk PCI: instructions for use and clinical reference manual 2018"},{"issue":"10","key":"i1526-6702-48-3-e207260-b23","series-title":"Am J Cardiol","first-page":"1624","article-title":"Clinical features and outcomes in adults with cardiogenic shock supported by extracorporeal membrane oxygenation","volume":"116","year":"2015","unstructured":"Carroll\n              BJ,\n            \n            \n              Shah\n              RV,\n   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assist device through an axillary access is a promising approach to improve outcomes in refractory cardiogenic shock patients.\n\t\t\t\t\tASAIO J2015;61(3):253\u20138."}],"container-title":["Texas Heart Institute 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