Abstract 1282 Left ventricle unloading and valvular integrity following microaxial mechanical support: a two year follow-up study

Aims

Although the use of microaxilar mechanical circulatory support (MCS) systems may improve the outcome of patients with cardiogenic shock (CS) due to myocardial infarction, 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.

Methods

84 consecutive patients were monitored over 2 years having received ImpellaTM CP or 2.5 for refractory CS or for high risk percutaneous coronary interventions (protected-PCI) followed by optimal medical treatment.

Results

62 patients were treated for severe CS and compared with 22 patients receiving short-term MCS for protected-PCI. 24 patients of the total population received Impella CP and the remaining 60 patients received Impella 2.5. Beside a significant increase in LV ejection fraction after 2 years (p≤0.03 vs. pre-implantation) in total cohort, we observed a statistically significant decrease in LV dilation (p<0.001) and severity of mitral valve regurgitation (p=0.007) in the 2 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 (p=revealed any devastating impact on aortic or mitral valve integrity.

Conclusions

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.

Clin Res Cardiol (2023). https://doi.org/10.1007/s00392-023-02180-w
Left ventricle unloading and valvular integrity following microaxial mechanical support: a two year follow-up study
G. Chatzis¹, K. Karatolios², H. Ahrens¹, H. Schütt¹, B. Markus³, D. Divchev¹, K. Sassani³, C. Wächter¹, N. Patsalis³, B. Schieffer³, S. Syntila³
¹Klinik für Innere Medizin - Schwerpunkt Kardiologie, Universitätsklinikum Giessen und Marburg GmbH, Marburg; ²IPZ Gießen, Internistisches Praxiszentrum, Gießen; ³Klinik für Kardiologie, Angiologie und internistische Intensivmedizin, Universitätsklinikum Giessen und Marburg GmbH, Marburg;
Aims Although the use of microaxilar mechanical circulatory support (MCS) systems may improve the outcome of patients with cardiogenic shock (CS) due to myocardial infarction, 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. Methods 84 consecutive patients were monitored over 2 years having received ImpellaTM CP or 2.5 for refractory CS or for high risk percutaneous coronary interventions (protected-PCI) followed by optimal medical treatment. Results 62 patients were treated for severe CS and compared with 22 patients receiving short-term MCS for protected-PCI. 24 patients of the total population received Impella CP and the remaining 60 patients received Impella 2.5. Beside a significant increase in LV ejection fraction after 2 years (p≤0.03 vs. pre-implantation) in total cohort, we observed a statistically significant decrease in LV dilation (p<0.001) and severity of mitral valve regurgitation (p=0.007) in the 2 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 (p=revealed any devastating impact on aortic or mitral valve integrity. Conclusions 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.
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