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Multicenter Study
. 2025 Oct;44(10):1668-1671.
doi: 10.1016/j.healun.2025.06.007. Epub 2025 Jun 10.

Multi-institutional outcomes of Impella use in pediatric patients: A brief communication from the ACTION Network

Jonathan B Edelson  1 , Shahnawaz Amdani  2 , David N Rosenthal  3 , Benjamin Kroslowitz  4 , Brian Morray  5 , Sabrina Law  6 , Anna Joong  7 , Sarah Wilkens  8 , David M Peng  9 , Michelle Ploutz  10 , Jenna Murray  3 , Jodie Lantz  11 , Jesse J Esch  12 , Mehreen Iqbal  11 , Timothy Lancaster  9 , Christina VanderPluym  12 , Aamir Jeewa  13 , Svetlana Shugh  14 , Mohammad Absi  15 , Muhammad Shezad  4 , Matthew J O'Connor  16 , Angela Lorts  4 , Sebastian Tume  17
Affiliations
Multicenter Study

Multi-institutional outcomes of Impella use in pediatric patients: A brief communication from the ACTION Network

Jonathan B Edelson et al. J Heart Lung Transplant. 2025 Oct.

Abstract

This retrospective cohort study includes 150 pediatric patients supported with the Impella between April 2018 and November 2024. Median weight was 62.9 kg (interquartile range [IQR] 51.0-79.7 kg) and the smallest weighed 19.0 kg. Axillary artery implants occurred in 40.1% of patients while the femoral artery was used in 29%. Most patients had dilated cardiomyopathy (57.3%); however, a significant portion had transplant graft dysfunction (14.7%) or congenital heart disease (13.3%). One quarter of the cohort (N = 38) were supported with extracorporeal membrane oxygenation (ECMO) before Impella; 76% (N = 29) used ECMO and Impella in tandem, while 24% (N = 9) transitioned from ECMO to Impella. Major bleeding, major infection, device malfunction, or stroke were reported in 28% of patients (N = 42). Positive clinical outcomes were achieved in 89.3% of patients; 32.7% explanted for recovery, 32% transplanted, and 23.3% changed to another device. These data demonstrate a potential role for this device in children with refractory advanced heart failure and a need for increased work to limit adverse events.

Keywords: ACTION; Impella; cardiogenic shock; mechanical circulatory support; pediatric heart failure.

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Conflict of interest statement

Disclosure statement J.E. receives grant support from the NIH under K23HL169833 and from Enduring Hearts, and consulting fees from Abbott and Abiomed. D.N.R. has received payment for expert testimony from Holgate, Slattery, Peterson, is the DSMB Chair for Berlin Heart Active Driver Trial, and is the codirector of ACTION. S.S. receives honoraria from Abiomed and participates on their advisory board. A.J. receives an unrestricted educational grant from Abbott, consulting fees from Berlin Heart, and serves on the CEC for Berlin Heart. D.P. is on the Berlin Heart EXCOR Active Trial Data Safety Monitoring Board. C.V.P. receives consulting fees from Abiomed and Astrazenaca and participates on the DSMB/Advisory board for the Merck Verciguat trial. A.L. receives grants or contracts from Abbott, Abiomed, Berlin, Bayor, Syncardia, and Medtronic, consulting fees from Abbott and participates on a DSMB or advisory board for Abiomed and International Society for Heart and Lung Transplantation.

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