Abstract
Background Surgically implanted Impella 5.5. delivers full cardiac support and left ventricular
unloading for patients with heart failure. So far, the Impella device is implanted
under general anesthesia (GA).
Material and Methods A total of n = 3 critically ill patients presented with acute heart failure in need of cardiac
support. All patients suffered cardiogenic shock of varying etiology. Due to hemodynamically
unstable conditions, GA was avoided. All implantations were performed solely under
local anesthesia (LAS) without any regional anesthesia.
Results All implantations were performed successfully under LAS with 60 mL of mepivacaine
of 2% solution and ropivacaine of 1% solution (50:50 ratio). All devices were placed
from the right axillary artery. One patient needed hematoma evacuation several days
after surgery. No other Impella-related complication was observed.
Conclusion A surgical implantation of the Impella 5.5 device under LAS is feasible and safe.
Despite the small number of cases, no disadvantage can be described at the present
moment. Our series should encourage physicians to perform the procedure under LAS.
Keywords
circulatory assist devices - heart failure - transplantation - heart - cardiomyopathy
