Options for mechanical circulatory support are limited in the pediatric population. The Impella (Abiomed, Danvers, MA) device is a percutaneously positioned, temporary, mechanical, circulatory device that has been shown in recent case series to be an effective means of support in the pediatric population. The primary limitations of its use in the pediatric population relate to size yet clear guidance regarding patient size parameters for implantation is lacking. The authors used data from 44 cardiac MRIs in healthy patients, 39 echocardiograms in patients with cardiomyopathy undergoing consideration for mechanical circulatory support, and device dimensions to extrapolate the anthropomorphic measurements that would likely be associated with successful implant. In patients being considered for ventricular assist device, an LV minimum length of 7.5 cm was associated with weight of 23 kg and body surface area of 0.89 m2, which was comparable to the MRI cohort. While each patient being considered for Impella implantation must be evaluated on an individual basis to determine if there is appropriate length in the LV to accommodate an Impella, this paper is the first to provide rough guidance regarding anthropomorphic measurements and feasibility.
All editors: Britton Keeshan, MD, MPH
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