<h2 class="section-title u-h4 u-margin-l-top u-margin-xs-bottom">Abstract</h2> <div id="as0005"> <h3 class="u-h4 u-margin-m-top u-margin-xs-bottom" id="st0010">Background/purpose</h3> <p id="sp0045"><span><a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/percutaneous-valve" title="Learn more about Percutaneous valve from ScienceDirect's AI-generated Topic Pages" class="topic-link">Percutaneous valve</a> interventions for <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/aortic-stenosis" title="Learn more about aortic stenosis from ScienceDirect's AI-generated Topic Pages" class="topic-link">aortic stenosis</a> (AS) include <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/percutaneous-aortic-valve-replacement" title="Learn more about transcatheter aortic valve replacement from ScienceDirect's AI-generated Topic Pages" class="topic-link">transcatheter aortic valve replacement</a> (TAVR) and balloon <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/aortic-valvuloplasty" title="Learn more about aortic valvuloplasty from ScienceDirect's AI-generated Topic Pages" class="topic-link">aortic valvuloplasty</a> (BAV). Intraprocedural mechanical </span><a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/assisted-circulation" title="Learn more about circulatory support from ScienceDirect's AI-generated Topic Pages" class="topic-link">circulatory support</a><span> (MCS) with Impella devices (Abiomed, Danvers, MA) is used in select high-risk patients, although data regarding its efficacy is limited. This study sought to evaluate the clinical outcomes of Impella use <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/inpatient" title="Learn more about in patients from ScienceDirect's AI-generated Topic Pages" class="topic-link">in patients</a> with AS who underwent TAVR and BAV at a quaternary-care center.</span></p> </div> <div id="as0010"> <h3 class="u-h4 u-margin-m-top u-margin-xs-bottom" id="st0015">Methods/materials</h3> <p id="sp0050">All patients with severe AS who underwent TAVR and BAV with Impella between 2013 and 2020 were included. Patient demographics, outcomes, complications, and 30-day mortality data was analyzed.</p> </div> <div id="as0015"> <h3 class="u-h4 u-margin-m-top u-margin-xs-bottom" id="st0020">Results</h3> <p id="sp0055">Over the study period 2680 procedures were performed, 1965 TAVR and 715 BAV. 120 utilized Impella support, 26 TAVR and 94 BAV. Among TAVR Impella cases, justifications for MCS included<span> </span><a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/cardiogenic-shock" title="Learn more about cardiogenic shock from ScienceDirect's AI-generated Topic Pages" class="topic-link">cardiogenic shock</a><span> (53.9 %), cardiac arrest (19.2 %), and <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/coronary-occlusion" title="Learn more about coronary occlusion from ScienceDirect's AI-generated Topic Pages" class="topic-link">coronary occlusion</a> (15.4 %). Among BAV Impella cases, justifications for MCS included cardiogenic shock (55.3 %) and protected percutaneous coronary intervention (43.6 %). The 30-day mortality rate in TAVR Impella was 34.6 % and in BAV Impella was 28 %. BAV Impella cases involving cardiogenic shock had a higher rate of 45 %. Impella remained in-use past 24 h from the procedure in 32.2 % cases. Vascular access-related complications occurred in 4.8 % cases and bleeding complications occurred in 1.5 % cases. Conversion to open-heart surgery occurred in 0.7 % cases.</span></p> </div> <div id="as0020"> <h3 class="u-h4 u-margin-m-top u-margin-xs-bottom" id="st0025">Conclusions</h3> <p id="sp0060">MCS is an option for high-risk patients with severe AS who require TAVR and BAV. Despite<span> </span><a href="https://www.sciencedirect.com/topics/biochemistry-genetics-and-molecular-biology/hemodynamic" title="Learn more about hemodynamic from ScienceDirect's AI-generated Topic Pages" class="topic-link">hemodynamic</a><span> </span>support, the 30-day mortality rate remained high especially in cases where support was employed for cardiogenic shock.</p> </div>