From impella to ecmella and everything in between. Shaare Zedek Heart Center present an excellent team work. - The 67th Annual Conference of the Israel Heart Society

BACKGROUND: Impella CP® and impella 5.0 (Abiomed, Danvers, MA) are percutaneously inserted ventricular assist device (VAD) that pump blood from the left ventricle into the ascending aorta and systemic circulation. Impella device actively unloads the left ventricle reducing the stroke-work and myocardial oxygen consumption while increasing the overall systemic cardiac output to support patients in cardiogenic shock as well as other high risk procedures.

OBJECTIVE: To summarize the different indications for the use of the Impella catheter and to investigate the safety and the 30-day mortality at Shaare Zedek Medical Center.

METHODS AND RESULTS: 16 patients received the Impella catheter between 2016 and 2019. Impella CP® was used in 15 patients and impella 5.0 L in one. 12 patients (75%) were males, mean age was 61.37 ±17.16

Procedure indication, type of access and 30 days outcome are presented in the following table:

Procedure	Impella Type	Access	Procedural mortality	Alive in 30 days
Protected PCI (6)	CP	Femoral A	0	6
Mitra Clip (4)	CP	Femoral A	0	4
Cardiogenic Shock (4) [3 Ecmella:Ecmo+Impella]	3 CP 1 5L (2 CP, 1 5L)	Femoral A Rt Axillary A	0 0	1
VT Ablation (1)	CP	Rt Sub Clavian A	0	1
Weaning from CPB (1)	CP	Femoral A	0	0

Implantation of the Impella CP® and 5.0 were successful in all cases. There were no procedural complications or mortality during the procedures. Three cardiogenic shock patients were connected simultaneously to extracorporeal membrane oxygenation (ECMELLA). Five patients (31%) died up to 30 days.

CONCLUSIONS: Our clinical experiences with the use of Impella CP® and impella 5 L heart pump demonstrated high safety procedure profile for various indications. Nevertheless, the mortality rate remains high among cardiogenic shock patients.