Retrospective analysis of circulatory support with the Impella CP® device in patients with therapy refractory cardiogenic shock

Background: In cardiogenic shock (CS) the Impella CP (R) device provides a fast available left ventricular circulatory support of up to 4.0 L/min. However, the use of the Impella CP (R) device was not systematically analysed yet. Methods: We performed a retrospective analysis of 28 consecutive patients suffering from severe therapy refractory CS treated with Impella CP (R). Mortality was estimated using the SAPS II-Score. Primary outcome was 30-day survival. We compared the different aetiologies of CS and the effect of additional extracorporeal life support (ECLS). Results: Aetiology of CS was acute coronary syndrome (ACS) in 15 patients, 9 patients received additional therapy with ECLS. SAPS II was 73 +/- 14, representing an estimated mortality of 87.1%. 18 patients deceased representing a 30-day survival of 36%. Comparing the different aetiologies, ACS-CS patients show a trend towards better survival. Additional therapy with ECLS did not change 30-day survival. In 3 cases, vascular complication needing surgical treatment occurred. All other patients showed no relevant complications except for the commonly seen haemolysis with consecutive need of transfusion. Conclusion: Our data could demonstrate that the Impella CP (R) application in these severely diseased patients is feasible and safe. Compared to the estimated mortality, the 30-day survival seems to be improved. (C) 2016 Elsevier Ireland Ltd. All rights reserved.