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Article Abstract
This retrospective cohort study includes 150 pediatric patients supported with the Impella between April 2018 and November 2024. Median weight was 62.9 kg (interquartile range [IQR] 51.0-79.7 kg) and the smallest weighed 19.0 kg. Axillary artery implants occurred in 40.1% of patients while the femoral artery was used in 29%. Most patients had dilated cardiomyopathy (57.3%); however, a significant portion had transplant graft dysfunction (14.7%) or congenital heart disease (13.3%). One quarter of the cohort (N = 38) were supported with extracorporeal membrane oxygenation (ECMO) before Impella; 76% (N = 29) used ECMO and Impella in tandem, while 24% (N = 9) transitioned from ECMO to Impella. Major bleeding, major infection, device malfunction, or stroke were reported in 28% of patients (N = 42). Positive clinical outcomes were achieved in 89.3% of patients; 32.7% explanted for recovery, 32% transplanted, and 23.3% changed to another device. These data demonstrate a potential role for this device in children with refractory advanced heart failure and a need for increased work to limit adverse events.
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