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Impella device

Henrik Vase, Steffen Christensen, Aage Christiansen, Christian Juhl Therkelsen, Evald Høj Christiansen, Hans Eiskjær, Steen Hvidtfeldt Poulsen
INTRODUCTION: Mechanical circulatory support may be considered as a therapeutic option in selected patients with refractory cardiac arrest (rCA). Animal studies suggest a potential role for the Impella(®) left ventricular assist device in this setting, but so far no human data have been published. METHODS: Eight patients with rCA were treated with the Impella CP(®) device at our institution from November 2014 to October 2015. The Impella CP(®) was used at the discretion of the treating physicians in patients with rCA and pulseless electrical activity with presumed primary left ventricular failure...
October 14, 2016: Resuscitation
N B Støttrup, L Jakobsen, L R Krusell, C J Terkelsen
No abstract text is available yet for this article.
September 22, 2016: International Journal of Cardiology
Kevin Ergle, Parham Parto, Selim R Krim
BACKGROUND: Despite recent advances in the management of heart failure, cardiogenic shock remains a challenging and devastating condition with significant morbidity and mortality. METHODS: We review currently available percutaneous mechanical circulatory support (MCS) devices and address each device's characteristics, mechanism of action, specific clinical indications, and contraindications. RESULTS: Four types of percutaneous MCS devices are currently available: the intraaortic balloon pump (IABP), Impella devices, the TandemHeart, and extracorporal membrane oxygenation (ECMO)...
2016: Ochsner Journal
Aditya Bansal, Jay K Bhama, Rajan Patel, Sapna Desai, Stacy A Mandras, Hamang Patel, Tyrone Collins, John P Reilly, Hector O Ventura, P Eugene Parrino
BACKGROUND: Outcomes of traditional mechanical support paradigms (extracorporeal membrane oxygenation, intraaortic balloon pump [IABP], and permanent left ventricular assist device [LVAD]) in acute decompensated heart failure have generally been suboptimal. Novel approaches, such as minimally invasive LVAD therapy (Impella 5.0 device), promise less invasive but equivalent hemodynamic support. However, it is yet unknown whether the outcomes with such devices support widespread acceptance of this new technology...
2016: Ochsner Journal
Sanjay Verma, Daniel Burkhoff, William W O'Neill
The rate of performing primary percutaneous coronary intervention in patients with complex coronary artery disease is increasing. The use of percutaneous mechanical circulatory support devices provides critical periprocedural hemodynamic support. Mechanical support has increased the safety and efficacy of interventional procedures in this high-risk patient population. Predicting patient response to the selected intervention can be clinically challenging. Here we demonstrate a case where complete hemodynamic collapse during PCI was avoided by mechanical support provided by the Impella device...
September 23, 2016: Catheterization and Cardiovascular Interventions
David Schibilsky, Tobias Kruger, Henning F Lausberg, Christoph Eisenlohr, Christoph Haller, Attila Nemeth, Barbara Schibilsky, Helene Haeberle, Peter Rosenberger, Tobias Walker, Christian Schlensak
The catheter-based Impella 5.0 left ventricular assist device is a powerful and less invasive alternative for patients in cardiogenic shock. The use as second-line therapy in patients with precedent extracorporeal life support (ECLS) has not been described before now. We analyzed our experience of consecutive patients treated with this alternative strategy. From April 2014 to December 2014, eight patients had been implanted as a second-line option after ECLS support. The reason for the change from ECLS to Impella 5...
September 2016: Artificial Organs
Dariusz Dudek, Tomasz Rakowski, Adam Sukiennik, Michał Hawranek, Artur Dziewierz, Jacek Kubica, Piotr Suwalski, Robert Gil, Wojciech Wojakowski, Andrzej Ochała, Wiesław Mazurek, Krzysztof Żmudka, Mariusz Gąsior
No abstract text is available yet for this article.
2016: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
Daniel Rüschen, Miriam Rimke, Jonas Gesenhues, Steffen Leonhardt, Marian Walter
BACKGROUND AND OBJECTIVES: Sufficient cardiac output is one of the main goals of ventricular assist device therapy. To date, there is no adequate method to estimate the combined amount of blood the native heart and a continuous-flow assist device pump through the circulatory system. This paper presents an approach to estimate total cardiac output based on the signals provided by optical pressure sensors mounted on the inlet and outlet of an Abiomed Impella CP pump. METHODS: Two Kalman filters were used in parallel for joint estimation of the aortic flow rate and the hydraulic resistance of the aortic valve...
August 30, 2016: Computer Methods and Programs in Biomedicine
Vikas Singh, Abdulla A Damluji, Rodrigo Mendirichaga, Carlos E Alfonso, Claudia A Martinez, Donald Williams, Alan W Heldman, Eduardo J de Marchena, William W O'Neill, Mauricio G Cohen
OBJECTIVE: Evaluate the use of mechanical circulatory support (MCS) devices in high-risk patients undergoing transcatheter aortic valve replacement (TAVR). BACKGROUND: The use of MCS devices in elderly patients with multiple comorbidities undergoing TAVR is underexplored. METHODS: All patients undergoing TAVR at a single tertiary academic center who required MCS during index procedure between 2008 and 2015 were included in a prospective database...
October 2016: Journal of Interventional Cardiology
Marco Robin Schroeter, Herdis Köhler, Astrid Wachter, Annalen Bleckmann, Gerd Hasenfuß, Wolfgang Schillinger
AIMS: Impella is a microaxial rotary pump that is placed across the aortic valve to expel aspirated blood from the left ventricle into the ascending aorta; it can be used in cardiogenic shock. While previous studies have evaluated the efficacy and safety of the Impella device, more clinically relevant data are necessary, especially with regard to outcomes. METHODS AND RESULTS: We screened our database of Impella patients in our heart center and found 68 consecutive patients who underwent Impella implantation due to acute coronary syndrome (ACS) complicated by cardiogenic shock...
August 15, 2016: Journal of Invasive Cardiology
Konstantinos Karatolios, Georgios Chatzis, Birgit Markus, Ulrich Luesebrink, Anette Richter, Bernhard Schieffer
BACKGROUND: Cardiogenic shock remains a clinical challenge with high mortality rate. Mechanical circulatory support (MCS) devices have become an integral component of the therapeutic armamentarium expanding the treatment options for refractory cardiogenic shock (RCS). METHODS: We included all consecutive patients with biventricular unloading with Impella-2.5 and VA-ECMO admitted for RCS between October 2013 and March 2015. Outcome data included survival to discharge, bridging to VAD and 28-day mortality...
November 1, 2016: International Journal of Cardiology
John R Spratt, Ganesh Raveendran, Kenneth Liao, Ranjit John
Temporary mechanical circulatory support (MCS) is a common supportive therapy in cardiogenic shock and high-risk coronary intervention. The proliferation of new percutaneous MCS devices allows support to be instituted rapidly without surgical cutdown. The recent literature exploring the indications, benefits, and risks of each is reviewed. Areas discussed: Current applications of percutaneous MCS devices, including intra-aortic balloon pumps (IAPB), Impella, TandemHeart, and VA ECMO are discussed. Studies investigating each were identified through a combination of online database queries and direct extraction of single studies cited in previously-identified papers...
October 2016: Expert Review of Cardiovascular Therapy
Dagmar M Ouweneel, Krischan D Sjauw, Esther M A Wiegerinck, Alexander Hirsch, Jan Baan, Bas A J M de Mol, Wim K Lagrand, R Nils Planken, José P S Henriques
OBJECTIVES: The use of intracardiac assist devices is expanding, and correct position of these devices is required for optimal functioning. The aortic valve is an important landmark for positioning of those devices. It would be of great value if the device position could be easily monitored on plain supine chest radiograph in the ICU. We introduce a ratio-based tool for determination of the aortic valve location on plain supine chest radiograph images, which can be used to evaluate intracardiac device position...
October 2016: Critical Care Medicine
Rajiv Tayal, Mihir Barvalia, Zeshan Rana, Benjamin LeSar, Humayun Ifthikar, Spas Kotev, Marc Cohen, Najam Wasty
Traditionally, brachial and common femoral arteries have served as access sites of choice, with many operators recently converting to radial artery access for coronary angiography and percutaneous intervention due to literature suggesting reduced bleeding risk, better patient outcomes, and lower hospital-associated costs. However, radial access has limitations when percutaneous procedures requiring larger sheath sizes are performed. Six Fr sheaths are considered the limit for safe use with the radial artery given that the typical luminal diameter of the vessel is approximately 2 mm, while peripheral artery disease (PAD) may often limit use of the common femoral artery, particularly in patients with multiple co-morbid risk factors...
September 2016: Journal of Invasive Cardiology
K Lackermair, S Sattler, B C Huber, U Grabmaier, L T Weckbach, A Bauer, H D Theiss, J Hausleiter, J Mehilli, S Massberg, S Brunner
BACKGROUND: In cardiogenic shock (CS) the Impella CP® device provides a fast available left ventricular circulatory support of up to 4.0L/min. However, the use of the Impella CP® device was not systematically analysed yet. METHODS: We performed a retrospective analysis of 28 consecutive patients suffering from severe therapy refractory CS treated with Impella CP®. Mortality was estimated using the SAPS II-Score. Primary outcome was 30-day survival. We compared the different aetiologies of CS and the effect of additional extracorporeal life support (ECLS)...
September 15, 2016: International Journal of Cardiology
Alexandros Briasoulis, Tesfaye Telila, Mohan Palla, Nestor Mercado, Ashok Kondur, Cindy Grines, Theodore Schreiber
High-risk percutaneous coronary intervention (PCI) is often offered to patients with extensive coronary artery disease, decreased left ventricular function, and co-morbid conditions that increase surgical risk. In these settings, percutaneous left ventricular assist devices (PVADs) can be used for hemodynamic support. To assess the effects of PVAD use on mortality, myocardial infarction, and complication rates in patients undergoing high-risk PCI, we systematically searched the electronic databases, MEDLINE, PUBMED, EMBASE, and Cochrane for prospective controlled trials and cohort studies of patients that received hemodynamic support with PVADs for high-risk PCI...
August 1, 2016: American Journal of Cardiology
Cesar Padilla, Antonio Hernandez Conte, Danny Ramzy, Michael Sanchez, Manxu Zhao, Donald Park, Lorraine Lubin
Peripartum cardiomyopathy is a rare form of heart failure with significant perioperative implications. In this case report, we describe a 34-year-old gravida 5, parity 3, patient who was admitted for an elective cesarean delivery. During the delivery, the patient developed sudden cardiac arrest and was emergently intubated in the operating room. An emergent transesophageal echocardiogram revealed a left ventricular ejection fraction of 10% with global biventricular hypokinesis. Urgent multidisciplinary consultations led to the rapid implementation of the Impella™ 2...
July 1, 2016: A & A Case Reports
Melissa K Webb, Jian Wang, Matthew S Riegel, Kristine J Guleserian, Joseph M Forbess, Thomas M Zellers, V Vivian Dimas
OBJECTIVE: This study's objective was to evaluate insertion techniques and device fit of the pediatric version of the Impella ventricular assist device in swine which had similar sized carotids and left ventricles (LVs) as children weighing 10-20 kg. BACKGROUND: Options for minimally invasive circulatory support in children are limited. A modified device based on the current Impella 2.5 platform was created in an effort to provide minimally invasive circulatory support for children...
May 24, 2016: Catheterization and Cardiovascular Interventions
Lukasz Kizner, Christian Flottmann, Dieter Horstkotte, Jan Gummert
The combined use of extracorporeal cardiac life support and the Impella left ventricular assist device is feasible in severe cardiogenic shock. Ischaemic complications due to the arterial cannulation may occur. The following cases show how the use of a perfusion adapter for bilateral antegrade leg perfusion prevents malperfusion of the lower extremities.
August 2016: Interactive Cardiovascular and Thoracic Surgery
Brian Lima, Parag Kale, Gonzalo V Gonzalez-Stawinski, Johannes J Kuiper, Sandra Carey, Shelley A Hall
Many patients with end-stage heart failure require mechanical circulatory support as a temporizing measure to enable multidisciplinary assessment for the most suitable therapeutic strategy. Impella 5.0 can be used as a bridge to decision to evaluate patients for potential recovery or bridge to next therapy (bridge to heart transplantation [BTHT] or bridge to durable left ventricular assist device or VAD [BLVAD]. Our goal was to examine single-center outcomes with the Impella 5.0 device as a bridge to next therapy (BTHT or BTLVAD)...
May 15, 2016: American Journal of Cardiology
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