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Impact of hemolysis during microaxial flow pump support on early outcomes after durable left ventricular assist device implantation

The impact of hemolysis during microaxial flow pump (mAFP; Impella, Danvers, Massachusetts, US) support on early outcomes after durable left ventricular assist device (d-LVAD) implantation is unknown. Three hundred and eleven consecutive patients undergoing d-LVAD implantation after mAFP support (Im...

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Autores principales: Gallone, Guglielmo (Autor) , Lewin, Daniel (Autor) , Spitaleri, Antonio (Autor) , Rojas Hernandez, Sebastian (Autor) , Bernhardt, Alexander (Autor) , Billion, Michael (Autor) , Meyer, Anna L. (Autor) , Netuka, Ivan (Autor) , Kooij, Janajade (Autor) , Pieri, Marina (Autor) , Szymanski, Mariusz (Autor) , Moeller, Christian (Autor) , Akhyari, Payam (Autor) , Jawad, Khalil (Autor) , Krasivskyi, Ihor (Autor) , Schmack, Bastian (Autor) , Färber, Gloria (Autor) , Medina, Marta (Autor) , Haneya, Assad (Autor) , Zimpfer, Daniel (Autor) , Nersesian, Gaik (Autor) , Lanmueller, Pia (Autor) , Oezkur, Mehmet (Autor) , Djordjevic, Ilija (Autor) , Saeed, Diyar (Autor) , Boffini, Massimo (Autor) , Stein, Julia (Autor) , Gustafsson, Finn (Autor) , Scandroglio, Anna Mara (Autor) , De Ferrari, Gaetano Maria (Autor) , Meyns, Bart (Autor) , Hofmann, Steffen (Autor) , Belohlavek, Jan (Autor) , Gummert, Jan (Autor) , Rinaldi, Mauro (Autor) , Potapov, Evgenij (Autor) , Loforte, Antonio (Autor)
Formato: Article (Journal)
Lenguaje:inglés
Publicado: March 2026
In: ASAIO journal
Year: 2026, Volumen: 72, Número: 3, Pages: 191-198
ISSN:1538-943X
DOI:10.1097/MAT.0000000000002451
Acceso en línea:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1097/MAT.0000000000002451
Verlag, lizenzpflichtig, Volltext: https://journals.lww.com/asaiojournal/abstract/2026/03000/impact_of_hemolysis_during_microaxial_flow_pump.3.aspx
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Notas de Autor:Guglielmo Gallone, Daniel Lewin, Antonio Spitaleri, Sebastian Rojas Hernandez, Alexander Bernhardt, Michael Billion, Anna Meyer, Ivan Netuka, Janajade Kooij, Marina Pieri, Mariusz Szymanski, Christian Moeller, Payam Akhyari, Khalil Jawad, Ihor Krasivskyi, Bastian Schmack, Gloria Färber, Marta Medina, Assad Haneya, Daniel Zimpfer, Gaik Nersesian, Pia Lanmueller, Mehmet Oezkur, Ilija Djordjevic, Diyar Saeed, Massimo Boffini, Julia Stein, Finn Gustafsson, Anna Mara Scandroglio, Gaetano Maria De Ferrari, Bart Meyns, Steffen Hofmann, Jan Belohlavek, Jan Gummert, Mauro Rinaldi, Evgenij Potapov, Antonio Loforte
Descripción
Sumario:The impact of hemolysis during microaxial flow pump (mAFP; Impella, Danvers, Massachusetts, US) support on early outcomes after durable left ventricular assist device (d-LVAD) implantation is unknown. Three hundred and eleven consecutive patients undergoing d-LVAD implantation after mAFP support (Impella 5.0/5.5 72.3%) were retrospectively included. The incidence and predictors of hemolysis (plasma-free hemoglobin >20 mg/dl or lactic dehydrogenase (LDH) >2.5-fold the upper reference limit) before d-LVAD implantation were assessed, along with its impact on early post-d-LVAD outcomes. The primary outcome was a composite of hemocompatibility-related adverse events (HRAEs: stroke/gastrointestinal bleeding/pump thrombosis). Hemolysis occurred in 40.8%. Impella 2.5/CP versus 5.0/5.5 was the single independent predictor of hemolysis (adj-hazard ratio [HR] = 2.68, 95% confidence interval [CI] = 1.04-6.94, p = 0.031). Post-d-LVAD HRAEs occurred more frequently among patients with hemolysis (31.9% vs. 20.6%; p = 0.041), mainly driven by hemorrhagic stroke and gastrointestinal bleeding. At multivariate analysis, hemolysis remained independently associated with HRAEs (adj-HR = 1.62, 95% CI = 1.02-2.58; p = 0.041). Patients with hemolysis were more likely to need a temporary right ventricular assist device following d-LVAD implantation (28.3% vs. 16.8%; p = 0.012), with no difference in mortality (23.6% vs. 21.2%; p = 0.355). In conclusion, among patients undergoing d-LVAD implantation with mAFP bridge, hemolysis is common, occurs more frequently among patients supported with Impella 2.5/CP, and is an independent predictor of post-d-LVAD HRAEs. - - - - - Export
Notas:Gesehen am 20.05.2026
Descripción Física:Online Resource
ISSN:1538-943X
DOI:10.1097/MAT.0000000000002451

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