As the propeller is accelerated to give respite to an acutely injured myocardium, the circulatory system transitions from a pulsatile mechanism to continuous flow.
[citation needed] However, recent studies point to significantly greater in-hospital risks of major bleeding, death, and other adverse events for patients supported by Impella devices, compared with those managed with an IABP.
[7] A propensity-matched comparison of patients receiving mechanical circulatory support (MCS) for myocardial infarction–related shock saw a nearly one-third excess in mortality and almost a doubling in risk of major bleeding, both in-hospital endpoints, with use of Impella compared to IABP.
[8] In patients with acute myocardial infarction complicated by cardiogenic shock, haemodynamic support with the Impella device had no significant effect on thirty-day mortality as compared with IABP.
Tech has allowed a single moving piece floated by magnetically steered mechanisms to deploy an "Archimedes Pump" just north of the Aortic Valve that purports to reduce both preload and afterload.
[14][18] Lastly, augmented cardiac output and forward flow from the left ventricle decreases pulmonary capillary wedge pressure and reduces right ventricular afterload.
In June 2008, the Impella 2.5 heart pump received FDA 510(k) clearance[22] for partial circulatory support for periods of up to six hours during cardiac procedures not requiring cardiopulmonary bypass.
[28] In July 2023, the FDA issued a Class I recall for all Impella left-sided blood pumps due to risk of motor damage after contact with a transcatheter aortic valve replacement stent.
[29][30] In March 2024, the FDA issued a warning about Impella left-sided blood pumps being linked to 49 deaths due to left ventricular perforation or wall rupture.