Impella Placement Guided by Echocardiography Can Be Used as a Strategy to Unload the Left Ventricle During Peripheral Venoarterial Extracorporeal Membrane Oxygenation

Journal of Cardiothoracic and Vascular Anesthesia
Amy G FiedlerGaston Cudemus

Abstract

At the authors' institution, before 2015, patients cannulated for peripheral venoarterial extracorporeal membrane oxygenation (VA-ECMO) did not undergo left ventricular (LV) decompression with the use of an LV vent. After 2015, the authors' institution began using the Impella device to vent the left ventricle in patients on VA-ECMO. The authors hypothesized that survival outcomes would improve in patients on VA-ECMO with the use of an Impella for LV venting. Retrospective, chart based review study. Single center, university-based hospital. All adult patients at the authors' institution who required VA-ECMO between January 2015 and May 2017. An Impella (Abiomed, Danvers, MA) device was placed percutaneously in patients cannulated for VA-ECMO as a mechanism to provide LV venting and decompression, therefore unloading the heart. Manual chart review was conducted, and a survival analysis was performed. It was observed that patients on VA-ECMO in whom an Impella was implanted had improved survival and an improvement in LV function as demonstrated by echocardiography compared with patients maintained on VA-ECMO alone. Patients on VA-ECMO plus Impella implantation demonstrated improved survival compared with patients treated with VA-E...Continue Reading

Citations

Feb 27, 2020·European Heart Journal. Case Reports·Johannes MierkeKarim Ibrahim
Apr 26, 2019·Herz·C SpiesA Hagendorff
Dec 14, 2019·Journal of Intensive Care Medicine·Aniket S RaliZubair Shah
Sep 19, 2019·Journal of Cardiothoracic and Vascular Anesthesia·Suneel Ramesh Desai, Nian Chih Hwang
Jul 1, 2020·Journal of Cardiothoracic and Vascular Anesthesia·Daniel S CormicanHarish Ramakrishna
Jul 12, 2021·Revista española de anestesiología y reanimación·I ZarragoikoetxeaR Vicente Guillén
Sep 4, 2021·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·John M TrahanasDavid A D'Alessandro
Jan 9, 2022·Echocardiography·Patrick T HusseyDylan R Addis

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