Acute cardiac care & resuscitation
Impella Malrotation Affects Left Ventricle Unloading in Cardiogenic Shock Patients
Authors' conclusion
In CS patients, Impella malrotation is associated with suboptimal unloading of the LV, worse pulmonary haemodynamics and worse indexes of right ventricular afterload.
Study context
- Population
- Cardiogenic shock patients on Impella support with echocardiography and pulmonary artery catheter assessmentmalrotation in 36%
- Participants
- 100 patients
- Exposure
- Impella malrotation vs no malrotation
- Outcome
- Haemodynamic consequences of Impella malrotation
- Follow-up
- 48 h
Main finding
As reported in the abstract
Pulmonary artery wedge pressure
P = 0.033
Observational data: associations, not effects.
Further findings
Systolic PAP · 48 h
P = 0.015
Diastolic PAP · 48 h
P = 0.007
Mean PAP · 48 h
P = 0.005
Right atrial pressure · 48 h
P = 0.009
Pulmonary vascular resistance index · 48 h
P = 0.020
Pulmonary artery elastance · 48 h
P = 0.045
Serum lactate · 48 h
P = 0.004
LVEDD during support
P = 0.006
Aortic regurgitation
P = 0.004
| Outcome | Malrotation | No malrotation | P value |
|---|---|---|---|
| Increase in AR severity | +0.94 ± 0.92 | + 0.46 ± 0.95 | P = 0.016 |
Safety
Major adverse outcomes
- No significant differences
Original publication
Impella Malrotation Affects Left Ventricle Unloading in Cardiogenic Shock Patients. ESC Heart Fail. Published 15 October 2024. doi:10.
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