{
  "abstract": "Objective\n\nMechanical circulatory support strategies for cardiogenic shock have traditionally relied on extracorporeal membrane oxygenation. However, newer high-flow ventricular support devices such as the Impella 5.5 device, capable of providing effective circulatory support, ventricular unloading, and early mobilization with fewer device-related complications, have begun to challenge the systematic use of an extracorporeal membrane oxygenation-first approach. The clinical evolution of patients treated with the Impella 5.5 device and the impact of different support trajectories remain poorly characterized. We describe the clinical evolution of patients treated with the Impella 5.5 device according to initial support trajectory, distinguishing primary implantation from transition after venoarterial extracorporeal membrane oxygenation.Methods\n\nThis multicenter observational study included 114 consecutive patients with advanced heart failure or cardiogenic shock who underwent Impella 5.5 implantation in Spanish heart transplant centers. Patients were classified according to initial support trajectory: primary Impella 5.5 implantation (n = 72) or initial venoarterial extracorporeal membrane oxygenation support followed by transition to Impella 5.5 (venoarterial extracorporeal membrane oxygenation to Impella 5.5 transition, n = 42). Baseline characteristics, clinical trajectories, complications, and in-hospital outcomes were analyzed.Results\n\nAll patients ultimately received Impella 5.5 device support. In-hospital mortality was 27.8% in the primary Impella group and 69.0% in the extracorporeal membrane oxygenation-Impella group (P < .001), with an overall mortality of 43.0%. Heart transplantation as definitive therapy was achieved in 76.4% and 31.0% of patients, respectively (P < .001).Conclusions\n\nIn transplant-oriented centers, outcomes among patients supported with the Impella 5.5 device appear to differ according to support trajectory. Primary implantation was associated with lower mortality and greater access to heart transplantation than transition from extracorporeal membrane oxygenation to the Impella 5.5 device.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Cardiac Surgery, Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas, As Xubias, A Coruña, Spain.",
    "Grupo de investigación Cardiopatía Estructural y Congénita, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas/Universidade da Coruña (UDC), As Xubias, A Coruña, Spain.",
    "Department of Cardiovascular Surgery, Virgen de la Arrixaca University Hospital, Murcia, Spain.",
    "Murcian Institute for Biosanitary Research (IMIB-Arrixaca), Murcia, Spain.",
    "Department of Cardiac Surgery, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain.",
    "Department of Cardiac Surgery, Marqués de Valdecilla University Hospital, Santander, Spain.",
    "Department of Cardiac Surgery, Gregorio Marañón University General Hospital, Madrid, Spain.",
    "Department of Cardiac Surgery, 12 de Octubre University Hospital, Madrid, Spain.",
    "Department of Cardiac Surgery, Puerta de Hierro-Majadahonda University Hospital, Majadahonda, Madrid, Spain.",
    "Department of Cardiac Surgery, Dr. Negrín University Hospital of Gran Canaria, Las Palmas de Gran Canaria, Spain.",
    "Department of Cardiac Surgery, Clínica Universidad de Navarra, Pamplona, Spain.",
    "Department of Cardiac Surgery, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.",
    "Grupo de Insuficiencia Cardiaca Avanzada y Trasplante Cardiaco, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas/Universidade da Coruña (UDC), As Xubias, A Coruña, Spain.",
    "Department of Cardiac Surgery, La Fe University and Polytechnic Hospital, Valencia, Spain."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 12,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "José Manuel Martínez-Comendador"
    },
    {
      "affs": [
        2,
        3
      ],
      "name": "Elio Martín Gutiérrez"
    },
    {
      "affs": [
        4
      ],
      "name": "Daniel Ortiz Berbel"
    },
    {
      "affs": [
        5
      ],
      "name": "Lucía García Alcalde"
    },
    {
      "affs": [
        6
      ],
      "name": "Álvaro Pedraz Prieto"
    },
    {
      "affs": [
        7
      ],
      "name": "Christian Muñoz Guijosa"
    },
    {
      "affs": [
        8
      ],
      "name": "Carlos Esteban Martín López"
    },
    {
      "affs": [
        9
      ],
      "name": "Stefano Urso"
    },
    {
      "affs": [
        10
      ],
      "name": "Gregorio Rábago Juan Aracil"
    },
    {
      "affs": [
        11
      ],
      "name": "Juan Bustamante-Munguira"
    },
    {
      "affs": [
        0,
        12
      ],
      "name": "José Joaquín Cuenca Castillo"
    },
    {
      "affs": [
        13
      ],
      "name": "Manuel Pérez Guillén"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/63bq5rbx4qvte.bib",
  "cited_by": 0,
  "doi": "10.1016/j.xjon.2026.101870",
  "fulltext_url": "https://europepmc.org/articles/PMC13711165",
  "id": "63bq5rbx4qvte",
  "issns": [
    "2666-2736"
  ],
  "landing_url": "https://europepmc.org/article/MED/42948469",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Adult: Mechanical Circulatory Support"
    ],
    [
      "openalex",
      "2204|Mechanical Circulatory Support Devices"
    ]
  ],
  "openalex": "W7162548739",
  "pdf_url": "https://europepmc.org/articles/PMC13711165?pdf=render",
  "pmcid": "PMC13711165",
  "pmid": "42948469",
  "published": "2026-05-27",
  "publisher": "Elsevier",
  "ris": "https://research.draconitic.com/paper/63bq5rbx4qvte.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T00:20:36Z",
      "native_id": "MED:42948469",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42948469"
    },
    {
      "first_seen": "2026-10-31T12:21:59Z",
      "native_id": "PMC13711165",
      "source": "pmc",
      "url": "https://doi.org/10.1016/j.xjon.2026.101870"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "journal-openalex:F27",
      "subfield": "general"
    }
  ],
  "title": "Clinical outcomes of primary Impella 5.5 versus transition from extracorporeal membrane oxygenation in cardiogenic shock: A Spanish multicenter cohort.",
  "title_text": "Clinical outcomes of primary Impella 5.5 versus transition from extracorporeal membrane oxygenation in cardiogenic shock: A Spanish multicenter cohort.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T12:21:59Z",
  "url": "https://research.draconitic.com/paper/63bq5rbx4qvte",
  "venue": "JTCVS open",
  "versions": []
}