The Impella Recover microaxial left ventricular assist device reduces mortality for postcardiotomy failure: a three-center experience

Siegenthaler, Michael; Brehm, Kerstin; Strecker, Thomas; Hanke, Thomas; Nötzold, A.; Olschewski, Manfred; Weyand, Michael; Sievers, Hans‐Hinrich; Beyersdorf, Friedhelm

doi:10.1016/j.jtcvs.2003.09.055

Cited by 128 publications

(68 citation statements)

References 11 publications

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“…Improved survival has been observed in cases with residual cardiac function higher than 1 L/min [1]. An adequate mean arterial pressure and cardiac output in absence of a peak of systolic pressure may guarantee peripheral organ perfusion unless a severe arterial stenosis is present as occurred in the case reported.…”

Section: Commentsmentioning

confidence: 69%

“…However cases of functional mitral stenosis secondary to pump placement have been reported [8]. Minimal blood damage during pumping and a light anticoagulation level required provide a low rate of hemorrhagic complications [1][2][3][4]. Fig.…”

Section: Commentsmentioning

confidence: 99%

“…It has been successfully used in postcardiotomy low out-put syndrome refractory to intra-aortic balloon pump and inotropic drugs [1][2][3]. It consists of a straight flexible cannula which is surgically inserted through the ascending aorta across the aortic valve into the left ventricle.…”

Section: Introductionmentioning

confidence: 99%

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Endocardial Injury During Ventricular Assistance with an Intracardiac Microaxial Pump

Fernández

Martínez²,

Alvarez³

et al. 2009

TOCTSJ

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Abstract:We report the case of a patient unweanable from cardiopulmonary bypass who underwent transaortic implantation of an Impella Recover LD blood pump. The ventricular assistance afforded an adequate flow but the patient died 48 hours after due to severe ischemia of the lower limbs. Chronic atherosclerotic occlusion of the abdominal aorta could be observed during the necropsy study as well as a subendocardial hematoma of the left ventricular wall. Some aspects concerning the pathologic finding observed in the heart are discussed.

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Section: Commentsmentioning

confidence: 69%

Section: Commentsmentioning

confidence: 99%

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Endocardial Injury During Ventricular Assistance with an Intracardiac Microaxial Pump

Fernández

Martínez²,

Alvarez³

et al. 2009

TOCTSJ

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“…The Impella device was associated with a higher level of hemolysis and one case of lower-limb ischemia following explantation (6). Other documented complications include sensor failure, functional mitral stenosis and displacement/repositioning (10)(11)(12).…”

Section: Discussionmentioning

confidence: 99%

“…On the whole, repositioning remains poorly examined. Siegenthaler et al (11), reviewing their experience with the Impella device, found that four of 24 patients (approximately 17%) required device repositioning. It is unknown from the published report whether this was echocardiographically guided.…”

Section: Discussionmentioning

confidence: 99%

Interprovincial spoke-to-hub transport using the Impella Recover LP 5.0 left ventricular assist device as a bridge to long-term circulatory support

Guirgis

Kumar

Zieroth

et al. 2010

Canadian Journal of Cardiology

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C urrent hospital administrative practices categorize health care centres in a network of spokes and hubs (1). The 'spokes' are primary care centres that offer immediate yet temporary life-sustaining therapies, and channel the most severe cases to centres or 'hubs' that can provide the long-term treatment not available at the spoke sites. In the setting of mechanical circulatory support, long-term left ventricular assist devices (LVADs) and transplant therapies are only used at a few hub centres. The relatively lower technical requirements of the Impella Recover LP 5.0 LVAD (ABIOMED Inc, USA) translate into greater utilization by spoke centres for the treatment of cardiogenic shock (2,3). Based on a literature review, we report the first case demonstrating successful use of the Impella Recover LP 5.0 LVAD, implanted under local anesthetic, for the purpose of interprovincial spoke-to-hub transport in a bridge-to-bridge-to-transplant procedure. case presentationMr S is a 54-year-old man with a greater than 10-year history of nonischemic dilated cardiomyopathy and symptomatic congestive heart failure managed medically. Following a sudden onset of angina, he presented to his local rural hospital and was diagnosed with an anterior ST elevation myocardial infarction complicated by high-grade atrioventricular block. Following stabilization with dopamine (5 µg/kg/min to 15 µg/kg/min) and insertion of a transvenous pacing wire, the patient was transferred to a tertiary care centre with cardiac surgery onsite, approximately 2 h away. On arrival, the patient had a blood pressure of 86/69 mmHg, a heart rate of approximately 70 beats/min (paced), a respiratory rate of 18 breaths/min and a hemoglobin saturation of 95% on 5 L supplemental oxygen. He had an increased jugular venous pressure of approximately 5 cm to 6 cm, with cool and clammy extremities. The electrocardiogram demonstrated third-degree atrioventricular block with increasing frequency of nonsustained ventricular tachycardia. He underwent emergent percutaneous coronary catheterizaton and thrombectomy of his proximal left anterior descending artery, with the remaining coronary arteries essentially unremarkable. The culprit lesion was not stented due to the patient's severe acetylsalicylic acid allergy and the potential need for heart transplantation. Despite restoration of Thrombolysis in Myocardial Infarction 3 flow following the procedure, the patient required increasing circulatory support, at which time an intra-aortic balloon pump (IABP) was inserted. The documented left ventricular end-diastolic pressure at this time was 39 mmHg. In the hours following, despite the use of inotropic Current hospital administrative practices categorize health care centres in a network of 'spokes' (primary care centres) and 'hubs' (tertiary care centres). For the treatment of cardiogenic shock, long-term left ventricular assist devices (LVADs) and transplant therapies are only used at a few hub centres nationwide and are, thus, only available to patients living in close proximit...

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Artificial Heart

Takatani

2006

Wiley Encyclopedia of Biomedical Engineering

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The artificial heart (AH) is a mechanical pump that partially or completely replaces the pumping function of the native heart. Two types of AH exist depending on use. The first is called ventricular assist device (VAD) and consists of a single pump to help the pumping function of the left or right ventricle, or both ventricles by combining two VADs without removing the native heart. The second AH is called total artificial heart (TAH) and is comprised of two pumps to maintain both lung circulation and systemic circulation after removal of the native heart.

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The Impella Recover microaxial left ventricular assist device reduces mortality for postcardiotomy failure: a three-center experience

Abstract: The Impella Recover device provides 3 to 4 L/min flow. It improves survival in patients with low-output syndrome if the heart is able to pump 1 L/min or more above device flow.

Cited by 128 publications

References 11 publications

Endocardial Injury During Ventricular Assistance with an Intracardiac Microaxial Pump

Endocardial Injury During Ventricular Assistance with an Intracardiac Microaxial Pump

Interprovincial spoke-to-hub transport using the Impella Recover LP 5.0 left ventricular assist device as a bridge to long-term circulatory support

Artificial Heart

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