Left Ventricular End‐Diastolic Diameter Predicts Clinical Outcomes in Patients Supported With Surgically Implanted Microaxial Flow Pump
- 1Columbia University Medical Center, New York Presbyterian Hospital
- 2Hospital of the University of Pennsylvania
- 3University of Pennsylvania Perelman School of Medicine
Abstract
Background This study sought to determine the impact of left ventricular size on clinical outcomes after a microaxial flow pump was surgically implanted. Methods In this retrospective cohort study, we included patients who received a surgical microaxial left ventricular assist device from May 2020 to February 2024 at 2 high‐volume centers in the United States. Patients were categorized into 2 groups based on their preimplant left ventricular end‐diastolic diameter (LVEDD): “small LVEDD,” defined as LVEDD ≤5.5 cm, and “large LVEDD,” defined as LVEDD >5.5 cm, respectively. End points were all‐cause death at 30 days after device implantation, in‐hospital death, death 30‐days after discharge, and survival at 30‐month follow‐up. Results Two‐hundred sixty‐two patients received an Impella 5.5. Preimplant LVEDD was documented in 194 (74%) patients, where 50 patients had LVEDD ≤5.5 cm and 144 patients had LVEDD >5.5 cm. Patients with a small LVEDD had a higher rate of all‐cause death at 30 days after device implantation (32% versus 11.8%, P =0.002), in‐hospital death (42% versus 20.1%, P =0.004), and death 30 days after discharge (44% versus 20.8%, P =0.003). In adjusted analyses, patients with a greater LVEDD had 62% decreased risk of long‐term death (hazard ratio, 0.39 [95% CI, 0.19–0.76]; P =0.001), compared with patients with a smaller LVEDD. Conclusions In this real‐world, all‐comer study, we found that patients with reduced left ventricular dimension who required an Impella 5.5 had worse outcomes. Further research is warranted to recapitulate our observations across more centers.
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BibTeX
@article{hassanabad2026left,
title = {{Left Ventricular End‐Diastolic Diameter Predicts Clinical Outcomes in Patients Supported With Surgically Implanted Microaxial Flow Pump}},
author = {Ali Fatehi Hassanabad and Yangling Zhao and Joseph G. Barile and Yuichiro Kitada and Gabriel Dardik and Justin Fried and Mauer Biscotti and Michael V. Genuardi and Marisa Cevasco and Koji Takeda},
journal = {Journal of the American Heart Association},
year = {2026},
month = oct,
doi = {10.1161/jaha.126.051803},
url = {https://www.ahajournals.org/doi/10.1161/JAHA.126.051803},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Left Ventricular End‐Diastolic Diameter Predicts Clinical Outcomes in Patients Supported With Surgically Implanted Microaxial Flow Pump
AU - Ali Fatehi Hassanabad
AU - Yangling Zhao
AU - Joseph G. Barile
AU - Yuichiro Kitada
AU - Gabriel Dardik
AU - Justin Fried
AU - Mauer Biscotti
AU - Michael V. Genuardi
AU - Marisa Cevasco
AU - Koji Takeda
PY - 2026
DA - 2026/10/20
JO - Journal of the American Heart Association
DO - 10.1161/jaha.126.051803
UR - https://www.ahajournals.org/doi/10.1161/JAHA.126.051803
AB - Background This study sought to determine the impact of left ventricular size on clinical outcomes after a microaxial flow pump was surgically implanted. Methods In this retrospective cohort study, we included patients who received a surgical microaxial left ventricular assist device from May 2020 to February 2024 at 2 high‐volume centers in the United States. Patients were categorized into 2 groups based on their preimplant left ventricular end‐diastolic diameter (LVEDD): “small LVEDD,” defined as LVEDD ≤5.5 cm, and “large LVEDD,” defined as LVEDD >5.5 cm, respectively. End points were all‐cause death at 30 days after device implantation, in‐hospital death, death 30‐days after discharge, and survival at 30‐month follow‐up. Results Two‐hundred sixty‐two patients received an Impella 5.5. Preimplant LVEDD was documented in 194 (74%) patients, where 50 patients had LVEDD ≤5.5 cm and 144 patients had LVEDD >5.5 cm. Patients with a small LVEDD had a higher rate of all‐cause death at 30 days after device implantation (32% versus 11.8%, P =0.002), in‐hospital death (42% versus 20.1%, P =0.004), and death 30 days after discharge (44% versus 20.8%, P =0.003). In adjusted analyses, patients with a greater LVEDD had 62% decreased risk of long‐term death (hazard ratio, 0.39 [95% CI, 0.19–0.76]; P =0.001), compared with patients with a smaller LVEDD. Conclusions In this real‐world, all‐comer study, we found that patients with reduced left ventricular dimension who required an Impella 5.5 had worse outcomes. Further research is warranted to recapitulate our observations across more centers.
SN - 2047-9980
ER -