The Impella Recover microaxial left ventricular assist device reduces mortality for postcardiotomy failure: a three-center experience M.P Siegenthaler,

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Presentation transcript:

The Impella Recover microaxial left ventricular assist device reduces mortality for postcardiotomy failure: a three-center experience M.P Siegenthaler, MD, K Brehm, MS, T Strecker, MD, T Hanke, MD, A Nötzold, MD, M Olschewski, MSc, M Weyand, MD, H Sievers, MD, F Beyersdorf, MD The Journal of Thoracic and Cardiovascular Surgery Volume 127, Issue 3, Pages 812-822 (March 2004) DOI: 10.1016/j.jtcvs.2003.09.055

Figure 1 A, Dimensions of the pump head of the Impella Recover microaxial left ventricular assist device. The device body is a flexible, wire-reinforced plastic tube to avoid potential mechanical damage by the pump head. B, The Impella Recover system is secured to the 10-mm Dacron prosthesis. C, An intraoperative transesophageal echocardiogram shows a correct position across the aortic valve. The Journal of Thoracic and Cardiovascular Surgery 2004 127, 812-822DOI: (10.1016/j.jtcvs.2003.09.055)

Figure 2 Bleeding and anticoagulation data of all Impella patients. A and B, Patients' chest tube output and transfusion requirements. C and D, Cumulative heparin dose given and results of the coagulation tests performed. The triangles (▴) represent patients who underwent a revision for bleeding; the other patients did not undergo surgical revision. ACT, Activated clotting time; aPTT, activated partial thromboplastin time; PRBC, packed red blood cells. The Journal of Thoracic and Cardiovascular Surgery 2004 127, 812-822DOI: (10.1016/j.jtcvs.2003.09.055)

Figure 3 The average pump flow (A) and pump rotations (B) per minute of the Impella Recover. The Journal of Thoracic and Cardiovascular Surgery 2004 127, 812-822DOI: (10.1016/j.jtcvs.2003.09.055)

Figure 4 Mortality rates (with 95% confidence interval) estimated from a logistic regression model with the (A) ICU score (n = 158), (B) THI score (n = 98), and (C) Hausmann score (n = 137) as a covariate in IABP patients. The solid boxes are the observed mortality rates within the different risk scores in the same population. The black circle (•) shows the actual survival in Impella patients with a residual cardiac function of 1 L/min or more (±SD), and the black triangle (▴) shows the survival of Impella patients with a residual cardiac function of 1 L/min or less (±SD). The Journal of Thoracic and Cardiovascular Surgery 2004 127, 812-822DOI: (10.1016/j.jtcvs.2003.09.055)

Figure 5 The residual cardiac function (cardiac output on the device − device flow) of 19 Impella patients is shown. Most patients with a residual function of 1 L/min or more survived (90%), as opposed to those with a residual function of 1 L/min or less (12%; P = .001). The Journal of Thoracic and Cardiovascular Surgery 2004 127, 812-822DOI: (10.1016/j.jtcvs.2003.09.055)