Mechanical Circulatory Support Devices
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The case of a 69-year-old male who presented with severe biventricular failure and cardiogenic shock who was bridged to heart transplantation (HT) utilizing a single Impella 5.5 for a total of 276 days is presented.
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The Impella 5.5 is a surgically implanted micro-axial left ventricular assist device (LVAD) increasingly utilized for mechanical circulatory support (MCS) in cardiogenic shock. While typically used for acute support up to FDA-approved 14 days, reports of prolonged utilization remain limited. We present the case of a 69-year-old male who presented with severe biventricular failure and cardiogenic shock who was bridged to heart transplantation (HT) utilizing a single Impella 5.5 for a total of 276 days. His prolonged support course was managed through a multidisciplinary approach addressing recurrent ventricular arrhythmias, renal failure, heparin-induced thrombocytopenia, and device management (suction alarms and purge flow limitations). Following successful HT, the explanted device demonstrated no mechanical injury or thrombus, and pathologic examination revealed no significant device-related structural heart damage. The patient was discharged without major complications and continued to do well at 5-month follow-up.
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@article{Shimamura2026Days,
title = {276 Days of Support by a Micro‐Axial Left Ventricular Assist Device as a Bridge to Heart Transplant},
author = {Junichi Shimamura and Avi Levine and Stephen Pan and Gregg M. Lanier and Chhaya Aggarwal and Alan Gass and David Spielvogel},
journal = {Artificial Organs},
year = {2026},
doi = {10.1111/aor.70225},
url = {https://doi.org/10.1111/aor.70225}
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