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Cardiac and Vascular Surgeons

Resources to improve outcomes for surgical patients

Impella 5.5 with SmartAssist and Low Cardiac Output Syndrome (LCOS)

LCOS, a state of cardiogenic shock with a 10% incidence rate, has multiple definitions with a common determination of hemodynamic instability requiring pharmacological or mechanical support.

Preoperative Considerations for LCOS

Identifying certain risk factors that can contribute to LCOS may inform the decision on treatment options.

Independent Predictors of LCOS Using Stepwise Logistic Regression Analysis

Selecting the Appropriate MCS Device

Impella 5.5 with SmartAssist delivers full cardiac support with maximum unloading, allowing the heart to rest and recover.

Despite pharmacological support, 10.1% of adults undergoing cardiac surgery develop LCOS.1 LCOS increase the risk of postoperative mortality by 12- to 25-fold.2-6

The emergence of LCOS after cardiac surgery significantly increases length of intensive care unit (ICU) and hospital stay, 30-day readmission rates and costs of treatment.

The occurrence of LCOS after cardiac surgery decreases the rate of hospital discharge to home from 80% to 50%. Moreover, LCOS increases the risk-adjusted hospital cost by an average of $16,000.1

  Cardiac Surgery with LCOS Cardiac Surgery without LCOS P-Value
Risk-adjusted hospital cost $64K $48K <0.001
Risk-adjusted length of stay 10.1 days 8.5 days <0.001
Risk-adjusted length of ICU stay 5.5 days 3.3 days <0.001
Provide myocardial rest 16.6% 13.9% <0.001
Discharged home 50% 80% <0.001


Improved Clinical Outcomes with Impella 5.5 with SmartAssist vs. Impella 5.0® in Cardiogenic Shock and Heart Failure Patients

Learn more about Impella 5.5

Impella 5.5 with SmartAssist Clinically Demonstrated Improvement in Overall Survival

Data from the First 200 Patients Treated

Survival and Recovery by Indication

Sustained results in >3,700 patients

Survival and Recovery by Indication

Explore the Education Library


Renal Recovery in HFCS with Impella 5.5 with SmartAssist

Rohan Goswami, MD, discusses renal recovery in patients with heart failure cardiogenic shock (HFCS) supported with Impella 5.5 with SmartAssist.


ECMO and pMCS for Advanced Cardiogenic Shock

Prof. Dr. Evgenij V. Potapov discusses combining extracorporeal life support (ECLS) with pMCS for treating advanced cardiogenic shock.

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Education and Resources

Explore case reviews, clinical data, ongoing studies, best practice resources, patient management tips and more

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Surgical Management of Cardiogenic Shock

Explore patient identification, clinical evidence, procedure and patient management resources

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Calculators and Tools

Support patient management with instant CPO/PAPi and heparin rate calculators to help achieve the best patient outcomes

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  1. Duncan, A. et al. (2022). J Thorac Cardiovasc Surg, 163(5), 1890-1898.e10
  2. Algarni, K. (2011), Ann Thorac Surg, 92(5), 1678-1684.
  3. Ding, W., et al. (2015), Int Heart J, 56(2), 144-149.
  4. Maganti, M., et al. (2005), Circulation, 112(9 suppl), 1448-1452.
  5. Maganti, M., et al. (2010), J Thorac Cardiovascular Surg, 140(4), 790-796.
  6. Sa, M., et al. (2012), Rev Bras Circ Cardiovasc, 27(2), 217-223.