The Impella 2.5 is a percutaneously placed partial circulatory assist device that is increasingly being used in high-risk coronary interventional procedures to provide hemodynamic support. The Impella 2.5 is able to unload the left ventricle rapidly and effectively and increase cardiac output more than an intra-aortic balloon catheter can. Potential complications include bleeding, limb ischemia, hemolysis, and infection. One community hospital's approach to establishing a multidisciplinary program for use of the Impella 2.5 is described.
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http://dx.doi.org/10.4037/ccn2011293 | DOI Listing |
Circ Rep
January 2025
Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine Chiba Japan.
Owing to recent advances in early reperfusion and pharmacological therapies, the prognosis of patients with acute myocardial infarction (AMI) has considerably improved over the past decades. However, the mortality rate remains high at ~40-50% after AMI when complicated by cardiogenic shock. Although immediate coronary revascularization of the infarct-related artery has been the only evidence-based treatment, temporary mechanical circulatory support with a microaxial flow pump (Impella) has become another therapeutic option supported by randomized trial data in highly selected patients.
View Article and Find Full Text PDFJ Cardiothorac Surg
January 2025
Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria.
Background: Left ventricular unloading is needed in patients on extracorporeal life support (ECLS) with severely impaired left ventricular contractility to avoid stasis and pulmonary congestion, and to promote LV recovery. The presence of thrombi in the LV precludes the use of conventional active unloading methods such as transaortic microaxial pumps or apical LV vents. We describe placement of a vent cannula via the left atrial appendage (LAA) as a useful bailout option.
View Article and Find Full Text PDFCurr Cardiol Rep
January 2025
Department of Cardiovascular & Thoracic Surgery, Sandra Atlas Bass Heart Hospital at North Shore University Hospital, Northwell Health, 300 Community Drive, 1 DSU, Manhasset, NY, 11030, USA.
Purpose Of Review: This article discusses a tailored approach to managing cardiogenic shock and temporary mechanical circulatory support (tMCS). We also outline specific mobilization strategies for patients with different tMCS devices and configurations, which can be enabled by this tailored approach to cardiogenic shock management.
Recent Findings: Safe and effective mobilization of patients with cardiogenic shock receiving tMCS can be accomplished.
Ann Thorac Surg Short Rep
December 2024
Department of Cardiovascular Surgery, Rinku General Medical Center, Osaka, Japan.
The mortality rate of postcardiotomy cardiogenic shock after cardiovascular surgery is quite high, and the only way to avoid this serious complication is to initiate a preemptive strategy during surgery. The Impella 5.5 device with the SmartAssist system (Abiomed) is mainly used to prevent or to treat cardiogenic shock in cardiac surgery, but it is not often used in aortic surgery.
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