TY - JOUR
T1 - Impact of the angle between aortic and mitral annulus on the occurrence of hemolysis during Impella support
AU - Nakamura, Makiko
AU - Imamura, Teruhiko
AU - Fukui, Takuya
AU - Hori, Masakazu
AU - Ueno, Yohei
AU - Uen, Hiroshi
AU - Kinugawa, Koichiro
N1 - Publisher Copyright:
© 2020, The Japanese Society for Artificial Organs.
PY - 2020/9/1
Y1 - 2020/9/1
N2 - Despite optimal management, we sometimes experience refractory hemolysis requiring extensive device speed reduction or continuous hemodiafiltration following Impella implantation. However, pre-procedural predictors of such a refractory hemolysis remain unknown. In this study, we investigated the pre-procedural factors, including the echocardiographic narrow angle between aortic and mitral annulus, associating with the occurrence of refractory hemolysis following Impella insertion. We enrolled 26 patients (71 years, 65% male) who received Impella insertion between March 2018 and November 2019. Among baseline characteristics, the angle between aortic and mitral annulus, < 126.5°, was an independent risk factor of refractory hemolysis with an adjusted hazard ratio of 7.840 (95% confidence interval 0.925–66.44) and was associated with lower 30-day survival (64% vs. 100%, p = 0.0116). The narrow angle between aortic and mitral annulus might be a useful tool to risk-stratify the occurrence of refractory hemolysis following Impella insertion.
AB - Despite optimal management, we sometimes experience refractory hemolysis requiring extensive device speed reduction or continuous hemodiafiltration following Impella implantation. However, pre-procedural predictors of such a refractory hemolysis remain unknown. In this study, we investigated the pre-procedural factors, including the echocardiographic narrow angle between aortic and mitral annulus, associating with the occurrence of refractory hemolysis following Impella insertion. We enrolled 26 patients (71 years, 65% male) who received Impella insertion between March 2018 and November 2019. Among baseline characteristics, the angle between aortic and mitral annulus, < 126.5°, was an independent risk factor of refractory hemolysis with an adjusted hazard ratio of 7.840 (95% confidence interval 0.925–66.44) and was associated with lower 30-day survival (64% vs. 100%, p = 0.0116). The narrow angle between aortic and mitral annulus might be a useful tool to risk-stratify the occurrence of refractory hemolysis following Impella insertion.
KW - Cardiogenic shock
KW - Left ventricular assist device
KW - Mechanical circulatory support
UR - http://www.scopus.com/inward/record.url?scp=85084730995&partnerID=8YFLogxK
U2 - 10.1007/s10047-020-01172-1
DO - 10.1007/s10047-020-01172-1
M3 - 学術論文
C2 - 32410011
AN - SCOPUS:85084730995
SN - 1434-7229
VL - 23
SP - 207
EP - 213
JO - Journal of Artificial Organs
JF - Journal of Artificial Organs
IS - 3
ER -