ECPELLA 5.5: An Evolution in the Management of Mechanical Circulatory Support.

There are several endovascular options for temporary mechanical circulatory support (MCS) in patients with refractory cardiogenic shock. These devices are often utilized in tandem to provide maximal support, including the combination of Veno-Arterial Extracorporeal Membrane Oxygenation (VA - ECMO) with the Impella device, termed ECPELLA. An underappreciated characteristic of MCS is whether they provide cardiac replacement and/or cardiac assistance. Within this framework, we propose an evolution in the approach to ECPELLA utilizing the Impella 5.5, with a focus on the Impella 5.5 as the primary support device.