Chauhan Akshay, Senzai Mikiko, Vijayapuri Sriram, Kehara Hiromu, Yanagida Roh, Krishan Kewal, Toyoda Yoshiya
Department of Cardiovascular Surgery, Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19004 USA.
Indian J Thorac Cardiovasc Surg. 2025 Jul;41(7):906-910. doi: 10.1007/s12055-025-01946-3. Epub 2025 Apr 21.
The Impella 5.5 (Abiomed, Danvers, MA, USA) is an advanced left ventricular assist device that provides short-term cardiac support for patients with severe heart failure and cardiogenic shock. Its compact size and catheter-based design facilitate relatively straightforward insertion, offering mechanical support to the left ventricle without significantly increasing afterload-two key advantages. A substantial body of clinical trials and real-world evidence have confirmed its efficacy in enhancing cardiac output and organ perfusion. Notably, its short-term support has been associated with improved patient outcomes in cases of cardiogenic shock. However, the use of Impella is not without risks, including bleeding events, peripheral vascular complications, and hemolysis, underscoring the importance of appropriate patient selection, surgical planning, and meticulous post-insertion management. Future research should focus on long-term outcomes, cost-effectiveness, and continued advancements in technology. This review provides a comprehensive analysis of the Impella device, including its design, clinical applications, surgical strategies, benefits, and indications, as well as the challenges associated with its use. It reassesses its role considering the most recent evidence.
Impella 5.5(美国马萨诸塞州丹弗斯市的Abiomed公司生产)是一种先进的左心室辅助装置,为严重心力衰竭和心源性休克患者提供短期心脏支持。其紧凑的尺寸和基于导管的设计便于相对直接的插入,在不显著增加后负荷的情况下为左心室提供机械支持——这是两个关键优势。大量的临床试验和实际证据证实了其在增加心输出量和器官灌注方面的疗效。值得注意的是,在治疗心源性休克时,其短期支持与改善患者预后相关。然而,使用Impella并非没有风险,包括出血事件、外周血管并发症和溶血,这凸显了适当的患者选择、手术规划和插入后精心管理的重要性。未来的研究应关注长期结果、成本效益以及技术的持续进步。本综述对Impella装置进行了全面分析,包括其设计、临床应用、手术策略、益处和适应症,以及与使用相关的挑战。它根据最新证据重新评估了其作用。