IS case 537: Impella recover LP 2.5 micro-axial pump placement

Wade Hedegard, MD

University of Rochester


Imaging Sciences URMC 2010
Publication Date: 2010-09-17

History

Patient is a 57-year-old male with heart failure, multivessel coronary artery disease and cardiogenic shock.

Findings

Chest x-ray demonstrates a left-sided AICD device and a right internal jugular Swan-Ganz catheter. Additionally, there is a third device which projects over the ascending aorta and left ventricle. There is also cardiomegaly and mild pulmonary edema.

Diagnosis

Impella recover LP 2.5 micro-axial pump placement

Discussion

The Impella LP 2.5 device is a new cardiac device that is used for short-term support in conditions characterized by severe decreased ventricular function and multivessel coronary artery disease. The device is a percutaneous left ventricular assist device which acts as a intravascular blood pump. The device is introduced through a 13-F femoral sheath and is placed across the aortic valve where it aspirates blood from the left ventricle and expels it into the ascending aorta. This serves to augment left ventricular function during high-risk percutaneous coronary artery interventions. The device can deliver an output up to 2.5 L/min and can be left in place for up to 5 days. The majority of patients who receive this device are poor surgical candidates for coronary artery bypass grafting. Recognition and differentiation of this device from other cardiac devices is useful when reading ICU chest x-rays.

References

  1. Thomopoulou S, Manginas A, Cokkinos DV. Initial experience with the Impella Recover LP 2.5 micro-axial pump in patients undergoing high-risk coronary angioplasty. Hellenic J Cardiol. 2008 Nov-Dec;49(6):382-7. PMID: 19110924

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