Options for mechanical circulatory support are limited in patients with single ventricle (SV) anatomy. The Impella (Abiomed, Danvers, MA) device is a percutaneously positioned, temporary, mechanical, circulatory device that has been approved for use during high-risk coronary interventions and cardiogenic shock following myocardial infarction. While recent publications have described Impella’s use as a temporary support in the pediatric population, use and outcomes in the single ventricle anatomy are largely unknown. The authors report the experience of 10 patients at multiple centers. Median age was 26 years (4-38 years) with median weight of 64 kg (15-102 kg). The primary indication for device was systemic ventricular failure (80%) and duration of implantation was 2.7-264 hrs. Of those patients, five patients had device explanted secondary to ventricular recovery, two patients were transitioned to more durable device and one patient died. Adverse events related to the device included hemolysis, aortic valve insufficiency and access site thrombus. Overall, the paper suggests that Impella can provide temporary mechanical circulatory support in some single ventricle patients with overall favorable outcomes.
All editors: Britton Keeshan, MD, MPH
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