IS case 470: Impella ventricular assist device

Nate Johnson, MD

University of Rochester

Imaging Sciences URMC 2010
Publication Date: 2010-08-30

History

Patient is a 39-year-old male presenting with shortness of breath and peripheral edema consistent with heart failure. The patient has a history of heart failure.

Findings

See images

Diagnosis

Impella ventricular assist device

Discussion

Ventricular assist devices are designed to:

* Directly unload volume from the strained ventricle. * Reduce myocardial workload and oxygen consumption. * Increase cardiac output.

The Impella ventricular assist device is a relatively new circulatory aid.

* Distal end with pigtail is within the left ventricle and contains inflow tract for pump. * Proximal end of thick (12Fr) portion is within the aorta and contains outflow tract for pump. * The thick part of the device contains a pump that offloads up to 2.5 L minute from the left ventricle.

Insertion of the device is less traumatic than standard ventricular assist device.

* Inserted in cath lab. * Common femoral artery approach via aorta, across the valve and into the left ventricle.

References

Meyns B, Dens J, Sergeant P, et al. Initial experiences with the Impella device in patients with cardiogenic shock - Impella support for cardiogenic shock. Thorac Cardiovasc Surg. 2003 Dec;51(6):312-7. PMID: 14669126
http://www.abiomed.com/products/impella.cfm