276 Days of Support by a Micro‐Axial Left Ventricular Assist Device as a Bridge to Heart Transplant

ABSTRACT

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.