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Adverse Events of Percutaneous Microaxial Left Ventricular Assist Devices—A Retrospective, Single-Centre Cohort Study

Worldwide, the left ventricular assist device Impella(®) (Abiomed, Danvers, MA, USA) is increasingly implanted in patients with acute cardiogenic shock or undergoing high-risk cardiac interventions. Despite its long history of use, few studies have assessed its safety and possible complications asso...

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Autores principales: Zaiser, Anna S., Fahrni, Gregor, Hollinger, Alexa, Knobel, Demian T., Bovey, Yann, Zellweger, Núria M., Buser, Andreas, Santer, David, Pargger, Hans, Gebhard, Caroline E., Siegemund, Martin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8396891/
https://www.ncbi.nlm.nih.gov/pubmed/34442010
http://dx.doi.org/10.3390/jcm10163710
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author Zaiser, Anna S.
Fahrni, Gregor
Hollinger, Alexa
Knobel, Demian T.
Bovey, Yann
Zellweger, Núria M.
Buser, Andreas
Santer, David
Pargger, Hans
Gebhard, Caroline E.
Siegemund, Martin
author_facet Zaiser, Anna S.
Fahrni, Gregor
Hollinger, Alexa
Knobel, Demian T.
Bovey, Yann
Zellweger, Núria M.
Buser, Andreas
Santer, David
Pargger, Hans
Gebhard, Caroline E.
Siegemund, Martin
author_sort Zaiser, Anna S.
collection PubMed
description Worldwide, the left ventricular assist device Impella(®) (Abiomed, Danvers, MA, USA) is increasingly implanted in patients with acute cardiogenic shock or undergoing high-risk cardiac interventions. Despite its long history of use, few studies have assessed its safety and possible complications associated with its use. All patients treated with a left-sided Impella(®) device at the University Hospital of Basel from 1 January 2011 to 31 December 2019 were enrolled. The primary endpoint was the composite rate of mortality and adverse events (bleeding, acute kidney injury, and limb ischemia). Out of 281 included patients, at least one adverse event was present in 262 patients (93%). Rates of in-hospital, 90-day, and one-year mortality were 48%, 47%, and 50%, respectively. BARC type 3 bleeding (62%) and hemolysis (41.6%) were the most common complications. AKI was observed in 50% of all patients. Renal replacement therapy was required in 97 (35%) of all patients. Limb ischemia occurred in 13% of cases. Bleeding and hemolysis are common Impella(®)-associated complications. Additionally, we found a high rate of AKI. A careful selection of patients receiving microaxial LV support and defining the indication for its use are essential measures to be taken for the benefits to outweigh potential complications.
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spelling pubmed-83968912021-08-28 Adverse Events of Percutaneous Microaxial Left Ventricular Assist Devices—A Retrospective, Single-Centre Cohort Study Zaiser, Anna S. Fahrni, Gregor Hollinger, Alexa Knobel, Demian T. Bovey, Yann Zellweger, Núria M. Buser, Andreas Santer, David Pargger, Hans Gebhard, Caroline E. Siegemund, Martin J Clin Med Article Worldwide, the left ventricular assist device Impella(®) (Abiomed, Danvers, MA, USA) is increasingly implanted in patients with acute cardiogenic shock or undergoing high-risk cardiac interventions. Despite its long history of use, few studies have assessed its safety and possible complications associated with its use. All patients treated with a left-sided Impella(®) device at the University Hospital of Basel from 1 January 2011 to 31 December 2019 were enrolled. The primary endpoint was the composite rate of mortality and adverse events (bleeding, acute kidney injury, and limb ischemia). Out of 281 included patients, at least one adverse event was present in 262 patients (93%). Rates of in-hospital, 90-day, and one-year mortality were 48%, 47%, and 50%, respectively. BARC type 3 bleeding (62%) and hemolysis (41.6%) were the most common complications. AKI was observed in 50% of all patients. Renal replacement therapy was required in 97 (35%) of all patients. Limb ischemia occurred in 13% of cases. Bleeding and hemolysis are common Impella(®)-associated complications. Additionally, we found a high rate of AKI. A careful selection of patients receiving microaxial LV support and defining the indication for its use are essential measures to be taken for the benefits to outweigh potential complications. MDPI 2021-08-20 /pmc/articles/PMC8396891/ /pubmed/34442010 http://dx.doi.org/10.3390/jcm10163710 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Zaiser, Anna S.
Fahrni, Gregor
Hollinger, Alexa
Knobel, Demian T.
Bovey, Yann
Zellweger, Núria M.
Buser, Andreas
Santer, David
Pargger, Hans
Gebhard, Caroline E.
Siegemund, Martin
Adverse Events of Percutaneous Microaxial Left Ventricular Assist Devices—A Retrospective, Single-Centre Cohort Study
title Adverse Events of Percutaneous Microaxial Left Ventricular Assist Devices—A Retrospective, Single-Centre Cohort Study
title_full Adverse Events of Percutaneous Microaxial Left Ventricular Assist Devices—A Retrospective, Single-Centre Cohort Study
title_fullStr Adverse Events of Percutaneous Microaxial Left Ventricular Assist Devices—A Retrospective, Single-Centre Cohort Study
title_full_unstemmed Adverse Events of Percutaneous Microaxial Left Ventricular Assist Devices—A Retrospective, Single-Centre Cohort Study
title_short Adverse Events of Percutaneous Microaxial Left Ventricular Assist Devices—A Retrospective, Single-Centre Cohort Study
title_sort adverse events of percutaneous microaxial left ventricular assist devices—a retrospective, single-centre cohort study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8396891/
https://www.ncbi.nlm.nih.gov/pubmed/34442010
http://dx.doi.org/10.3390/jcm10163710
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