ArticleESC heart failure2025
Impella malrotation affects left ventricle unloading in cardiogenic shock patients.
Article in ESC heart failure, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Axial Flow Percutaneous Ventricular Assist Devices: Physiology, Procedural Considerations, and Clinical Applications-A State-of-the-Art Review.Structural heart : the journal of the Heart Team · 2026Review
- Echocardiographic Assessment Before, During, and After Impella Positioning: State of the Art.Journal of clinical medicine · 2026Review
- Cardiogenic shock in the course of myocardial infarction: the results of the Shock-POL registry.ESC heart failure · 2026Article
- Impella malrotation affects left ventricle unloading in cardiogenic shock patients.ESC heart failure · 2025Article
- Echocardiography for short-term mechanical circulatory support: a trans-Atlantic practical guide.European heart journal. Imaging methods and practice · 2025Review
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Authors and funding
15 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsImpella malrotation-inlet orientation away from the left ventricular (LV) apex with normal console waveforms and proper device depth-is commonly observed and possibly associated worse haemodynamics. This study aimed to characterize the haemodynamic consequences of Impella malrotation in cardiogenic shock (CS) patients. METHODS AND
resultsWe included 100 CS patients (60 ± 12 years; 79.0% males) with available echocardiography during Impella support and pulmonary artery catheter assessment before and during (at 48 h) Impella support. Impella malrotation was identified in 36%. At 48 h, malrotation patients had higher pulmonary artery wedge pressure (PAWP, 16.0 ± 8.2 vs. 13.0 ± 4.6 mmHg; P = 0.033), higher systolic pulmonary artery pressure (PAP, 35.0 ± 11.3 vs. 29.5 ± 9.0 mmHg; P = 0.015), higher diastolic-PAP (19.3 ± 8.1 vs. 15.1 ± 6.1 mmHg; P = 0.007), higher mean-PAP (25.7 ± 9.1 vs. 20.8 ± 6.8 mmHg; P = 0.005), higher right atrial pressure (10.3 ± 4.8 vs. 7.7 ± 4.3 mmHg; P = 0.009), higher pulmonary vascular resistance index (4.78 ± 2.75 vs. 3.49 ± 1.94 WUm
conclusionsIn CS patients, Impella malrotation is associated with suboptimal unloading of the LV, worse pulmonary haemodynamics and worse indexes of right ventricular afterload.
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