{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T14:55:55Z","timestamp":1790088955166,"version":"4.0.1"},"reference-count":21,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2021,3,18]],"date-time":"2021-03-18T00:00:00Z","timestamp":1616025600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Although the use of microaxilar mechanical circulatory support systems may improve the outcome of patients with cardiogenic shock (CS), little is known about its effect on the long-term structural integrity of left ventricular (LV) valves as well as on the development of LV-architecture. Therefore, we aimed to study the integrity of the LV valves and architecture and function after Impella support. Thus, 84 consecutive patients were monitored over two years having received ImpellaTM CP (n = 24) or 2.5 (n = 60) for refractory CS (n = 62) or for high-risk percutaneous coronary interventions (n = 22) followed by optimal medical treatment. Beside a significant increase in LV ejection fraction after two years (p \u2264 0.03 vs. pre-implantation), we observed a statistically significant decrease in LV dilation (p &lt; 0.001) and severity of mitral valve regurgitation (p = 0.007) in the two-year follow-up period, suggesting an improved LV architecture. Neither the duration of support, nor the size of the Impella device or the indication for its use revealed any devastating impact on aortic or mitral valve integrity. These findings indicate that Impella device is a safe means of support of LV-function without detrimental long-term effects on the structural integrity of LV valves regardless of the size of the device or the indication of support.<\/jats:p>","DOI":"10.3390\/jcm10061273","type":"journal-article","created":{"date-parts":[[2021,3,18]],"date-time":"2021-03-18T22:19:36Z","timestamp":1616105976000},"page":"1273","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Left Ventricle Architecture and Valvular Integrity Following Microaxial Mechanical Support: A Two-Year Follow-Up Study"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2258-0846","authenticated-orcid":false,"given":"Georgios","family":"Chatzis","sequence":"first","affiliation":[{"name":"Department of Cardiology, Angiology and Intensive Care, Philipps University Marburg, 35043 Marburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Styliani","family":"Syntila","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Angiology and Intensive Care, Philipps University Marburg, 35043 Marburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harald","family":"Schuett","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Angiology and Intensive Care, Philipps University Marburg, 35043 Marburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1558-0696","authenticated-orcid":false,"given":"Christian","family":"Waechter","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Angiology and Intensive Care, Philipps University Marburg, 35043 Marburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holger","family":"Ahrens","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Angiology and Intensive Care, Philipps University Marburg, 35043 Marburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birgit","family":"Markus","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Angiology and Intensive Care, Philipps University Marburg, 35043 Marburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitar","family":"Divchev","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Angiology and Intensive Care, Philipps University Marburg, 35043 Marburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Rogmann","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Angiology and Intensive Care, Philipps University Marburg, 35043 Marburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos","family":"Karatolios","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Angiology and Intensive Care, Philipps University Marburg, 35043 Marburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios","family":"Bouras","sequence":"additional","affiliation":[{"name":"Yale School of Medicine, Yale University, New Heaven, CT 06510, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernhard","family":"Schieffer","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Angiology and Intensive Care, Philipps University Marburg, 35043 Marburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"Luesebrink","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Angiology and Intensive Care, Philipps University Marburg, 35043 Marburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,3,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1104","DOI":"10.1016\/j.amjcard.2018.05.040","article-title":"Evolving Concepts in Diagnosis and Management of Cardiogenic Shock","volume":"122","author":"Bellumkonda","year":"2018","journal-title":"Am. J. Cardiol"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1177\/2048872619860218","article-title":"Impact of microaxillar mechanical left ventricular support on renal resistive index in patients with cardiogenic shock after myocardial infarction: A pilot trial to predict renal organ dysfunction in cardiogenic shock","volume":"9","author":"Markus","year":"2019","journal-title":"Eur. Heart J. Acute Cardiovasc. Care"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1093\/icvts\/ivv305","article-title":"The Impella(R) Recover mechanical assist device in acute cardiogenic shock: A single-centre experience of 66 patients","volume":"22","author":"Schiller","year":"2016","journal-title":"Interact. Cardiovasc. Thorac. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1111\/joic.12172","article-title":"The use of Impella 2.5 in severe refractory cardiogenic shock complicating an acute myocardial infarction","volume":"28","author":"Casassus","year":"2015","journal-title":"J. Interv. Cardiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/j.resuscitation.2018.03.008","article-title":"Impella support compared to medical treatment for post-cardiac arrest shock after out of hospital cardiac arrest","volume":"126","author":"Karatolios","year":"2018","journal-title":"Resuscitation"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"684","DOI":"10.1016\/j.ijcard.2015.07.065","article-title":"Impella ventricular support in clinical practice: Collaborative viewpoint from a European expert user group","volume":"201","author":"Burzotta","year":"2015","journal-title":"Int. J. Cardiol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1717","DOI":"10.1161\/CIRCULATIONAHA.112.098194","article-title":"A prospective, randomized clinical trial of hemodynamic support with Impella 2.5 versus intra-aortic balloon pump in patients undergoing high-risk percutaneous coronary intervention: The PROTECT II study","volume":"126","author":"Kleiman","year":"2012","journal-title":"Circulation"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1002\/ccd.23403","article-title":"Real-world use of the Impella 2.5 circulatory support system in complex high-risk percutaneous coronary intervention: The USpella Registry","volume":"80","author":"Maini","year":"2012","journal-title":"Catheter. Cardiovasc. Interv."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1016\/j.jcin.2014.07.030","article-title":"Percutaneous circulatory assist devices for high-risk coronary intervention","volume":"8","author":"Myat","year":"2015","journal-title":"JACC Cardiovasc. Interv."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/j.jcin.2008.11.005","article-title":"A prospective feasibility trial investigating the use of the Impella 2.5 system in patients undergoing high-risk percutaneous coronary intervention (The PROTECT I Trial): Initial U.S. experience","volume":"2","author":"Dixon","year":"2009","journal-title":"JACC Cardiovasc. Interv."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"990","DOI":"10.1016\/j.amjcard.2005.10.037","article-title":"Safety and feasibility of elective high-risk percutaneous coronary intervention procedures with left ventricular support of the Impella Recover LP 2.5","volume":"97","author":"Henriques","year":"2006","journal-title":"Am. J. Cardiol"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1004","DOI":"10.2459\/JCM.0b013e3282f9abe7","article-title":"Feasibility and long-term safety of elective Impella-assisted high-risk percutaneous coronary intervention: A pilot two-centre study","volume":"9","author":"Burzotta","year":"2008","journal-title":"J. Cardiovasc. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1002\/ccd.27242","article-title":"Maintenance of valvular integrity with Impella left heart support: Results from the multicenter PROTECT II randomized study","volume":"92","author":"Goldstein","year":"2018","journal-title":"Catheter. Cardiovasc. Interv."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.echo.2018.06.004","article-title":"Guidelines for Performing a Comprehensive Transthoracic Echocardiographic Examination in Adults: Recommendations from the American Society of Echocardiography","volume":"32","author":"Mitchell","year":"2019","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"921","DOI":"10.1016\/j.echo.2013.07.009","article-title":"Guidelines for performing a comprehensive transesophageal echocardiographic examination: Recommendations from the American Society of Echocardiography and the Society of Cardiovascular Anesthesiologists","volume":"26","author":"Hahn","year":"2013","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e100","DOI":"10.1016\/j.hlc.2013.10.098","article-title":"Acute mitral regurgitation: Unforeseen new complication of the Impella LP 5.0 ventricular assist device and review of literature","volume":"23","author":"Elhussein","year":"2014","journal-title":"Heart Lung Circ."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1539","DOI":"10.1016\/j.amjcard.2016.02.007","article-title":"Perforation of the Anterior Mitral Leaflet After Impella LP 5.0 Therapy in Cardiogenic Shock","volume":"117","author":"Eftekhari","year":"2016","journal-title":"Am. J. Cardiol"},{"key":"ref_18","first-page":"412","article-title":"Functional mitral stenosis: A rare complication of the Impella assist device","volume":"9","author":"Toggweiler","year":"2008","journal-title":"Eur. J. Echocardiogr."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"734","DOI":"10.1001\/jama.2020.0254","article-title":"Association of Use of an Intravascular Microaxial Left Ventricular Assist Device vs Intra-aortic Balloon Pump With In-Hospital Mortality and Major Bleeding Among Patients With Acute Myocardial Infarction Complicated by Cardiogenic Shock","volume":"323","author":"Dhruva","year":"2020","journal-title":"JAMA"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1177\/2048872618805486","article-title":"Real-life use of left ventricular circulatory support with Impella in cardiogenic shock after acute myocardial infarction: 12 years AMC experience","volume":"8","author":"Ouweneel","year":"2019","journal-title":"Eur. Heart J. Acute Cardiovasc. Care"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1249","DOI":"10.1161\/CIRCULATIONAHA.118.036614","article-title":"Impella Support for Acute Myocardial Infarction Complicated by Cardiogenic Shock","volume":"139","author":"Schrage","year":"2019","journal-title":"Circulation"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/6\/1273\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:37:53Z","timestamp":1760161073000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/6\/1273"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,18]]},"references-count":21,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2021,3]]}},"alternative-id":["jcm10061273"],"URL":"https:\/\/doi.org\/10.3390\/jcm10061273","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,18]]}}}