Patient size parameters to guide use of the Impella device in pediatric patients

Brian H. Morray, Vasiliki V Dimas, Doff B. McElhinney, Kriti Puri, Athar M. Qureshi

Research output: Contribution to journalArticle

Abstract

Objectives: To define patient and ventricular size parameters to guide Impella device (Abiomed, Inc., Danvers, MA) placement for mechanical circulatory support (MCS) in small pediatric patients (10–30 kg). Background: There are few options for MCS in children, and there are no data on minimum patient size requirements for placement of the Impella 2.5 device. Methods: This was a multicenter study of echocardiographic and magnetic resonance imaging (MRI) derived dimensions of the left ventricle (LV) length and ascending aorta used to define minimum size parameters that are necessary for the placement of the Impella catheter. Results: Data were collected from 44 cardiac MRIs conducted in healthy pediatric patients and 39 echocardiograms performed in pediatric patients with cardiomyopathy prior to surgical ventricular assist device (VAD) placement. The Impella 2.5 catheter is 7.5 cm from the pigtail to the aortic annulus marker, thus requiring an LV apical length of 7.5 cm to allow the device to function in an unconstrained fashion. In the cohort of patients undergoing consideration for VAD placement, a minimum LV length of 7.5 cm corresponded to a height of 122 cm, weight of 23 kg, and body surface area (BSA) of 0.89 m2. In the MRI cohort, this corresponded to a height of 121 cm, weight of 23.9 kg, and BSA of 0.89 m2. Conclusion: MCS with Impella devices is feasible in pediatric patients. This study defines anthropomorphic and anatomic measurements to guide providers in patient selection for MCS using the Impella devices.

Original languageEnglish (US)
JournalCatheterization and Cardiovascular Interventions
DOIs
StateAccepted/In press - Jan 1 2019

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Pediatrics
Equipment and Supplies
Heart Ventricles
Heart-Assist Devices
Body Surface Area
Catheters
Magnetic Resonance Imaging
Weights and Measures
Cardiomyopathies
Patient Selection
Multicenter Studies
Aorta

Keywords

  • congenital heart disease
  • mechanical support
  • pediatrics

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Patient size parameters to guide use of the Impella device in pediatric patients. / Morray, Brian H.; Dimas, Vasiliki V; McElhinney, Doff B.; Puri, Kriti; Qureshi, Athar M.

In: Catheterization and Cardiovascular Interventions, 01.01.2019.

Research output: Contribution to journalArticle

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