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.
- Jonathan B. Edelson, MD, MSCE
- Shahnawaz Amdani, MD
- David N. Rosenthal, MD
- Benjamin Kroslowitz, MS
- Brian Morray, MD
- Sabrina Law, MD
- Anna Joong, MD
- Sarah Wilkens, MD
- David M. Peng, MD
- Michelle Ploutz, MD
- Jenna Murray, CRNP
- Jodie Lantz, MSN, APRN
- Jesse J. Esch, MD, MSS
- Mehreen Iqbal, MD
- Timothy Lancaster, MD
- Christina VanderPluym, MD
- Aamir Jeewa, MB, BCh
- Svetlana Shugh, MD
- Mohammad Absi, MD
- Muhammad Shezad, MS
- Matthew J. O’Connor, MD
- Angela Lorts, MD, MBA
- Sebastian Tume, MD
CITATION
Edelson, J., Amdani, S., Rosenthal, D. et al. Multi-institutional outcomes of Impella use in pediatric patients: A brief communication from the ACTION Network. The Journal of Heart and Lung Transplantation (2025). Volume 0, Issue 0. DOI: 10.1016/j.healun.2025.06.007
