The Lillie Frank Abercrombie Section of Cardiology, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA.
Morgan Stanley Children's Hospital of New York-Presbyterian, Columbia University Medical Center, New York, New York, USA.
Catheter Cardiovasc Interv. 2020 Aug;96(2):376-381. doi: 10.1002/ccd.28830. Epub 2020 Mar 4.
To assess the outcomes of the use of the percutaneous Impella RP device (Abiomed, Danvers, MA) in adolescents and young adults.
Results of the Impella RP device have been reported in adults, but a multicenter experience in adolescents and young adults has yet to be reported.
Patients ≤21 years of age who underwent implantation of an Impella RP device for refractory right heart failure from June, 2016 to April, 2018 at nine U.S. Centers were included.
A total of 12 adolescents, median age of 18 (14-21) years and median weight 74.4 (49-112.4) kg underwent Impella RP implantation (INTERMACS Profile 1 in nine and Profile 2 in three patients. The central venous pressure decreased from 20 (16-35) to 12 (7-17) mmHg, (p = .001). One patient was concomitantly supported with an intra-aortic balloon pump (IABP) and the rest with a percutaneous/surgically placed left ventricular assist device. There was one adverse event related to the Impella RP device (thrombosis requiring explant). The support duration was 6.5 days (4.8 hr-18.4 days) and survival to hospital discharge was 83%. At a median follow-up of 11 months (5 days-2.5 years), 8 of 12 (67%) patients are alive.
In this multicenter experience, the Impella RP device was found to be efficacious and safe when used in adolescents and young adults. Further studies are warranted to identify suitable young/pediatric candidates for Impella RP therapy for right heart failure.
评估经皮 Impella RP 装置（Abiomed，马萨诸塞州丹弗斯）在青少年和年轻成人中的应用效果。
Impella RP 装置的结果已在成人中报告，但尚未报告在青少年和年轻成人中的多中心经验。
纳入 2016 年 6 月至 2018 年 4 月在 9 个美国中心因难治性右心衰竭而植入 Impella RP 装置的≤21 岁患者。
共 12 例青少年，中位年龄 18（14-21）岁，中位体重 74.4（49-112.4）kg 接受 Impella RP 植入术（INTERMACS 1 型 9 例，2 型 3 例。中心静脉压从 20（16-35）mmHg 降至 12（7-17）mmHg，（p = 0.001）。1 例患者同时伴有主动脉内球囊反搏（IABP）支持，其余患者伴有经皮/外科左心室辅助装置。有 1 例与 Impella RP 装置相关的不良事件（血栓形成需要取出）。支持时间为 6.5 天（4.8 小时-18.4 天），存活率至出院为 83%。中位随访 11 个月（5 天-2.5 年）时，12 例患者中有 8 例（67%）存活。
在这项多中心研究中，发现 Impella RP 装置在青少年和年轻成人中是有效且安全的。需要进一步的研究来确定适合年轻/儿科患者接受 Impella RP 治疗右心衰竭的合适人选。
