Subscribe to RSS
Successful Treatment of Left Ventricular Perforation Occurring After Insertion of an Impella Device
The Impella device is a miniaturized ventricular assist device that is being increasingly used to increase the safety and efficacy of high-risk coronary interventions and to treat patients with acute myocardial infarction complicated by cardiogenic shock. The device has a miniaturized rotary pump mounted on a 9F catheter with a pigtail conformation. The pump draws blood from the left ventricular cavity and expels it into the ascending aorta and systemic circulation. We report a patient who, following insertion of an Impella device, developed angiographically documented left ventricular perforation with marked hemodynamic instability. Our successful management of this patient is described and potential mechanisms responsible for the perforation are discussed.
Keywordsleft ventricular perforation - impella device - ventricular assist device - cardiac surgery - high risk coronary intervention - tamponade - complication
30 July 2018 (online)
© 2020. Thieme. All rights reserved.
Thieme Medical Publishers
333 Seventh Avenue, New York, NY 10001, USA.
- 1 Burkhoff D, Moscucci M, Henriques JPS. Percutaneous Circulatory Support: Intraaortic Balloon Counterpulsation, Impella, TandemHeart, and Extracorporeal Bypass. In: Moscucci M. , ed. Grossman & Baim's Cardiac Catheterization, Angiography, and Intervention. 8th ed. Philadelphia, PA: Lippincott Williams &Wilkins; 2014: 601-625
- 2 Peritz DC, Linstroth L, Selzman CH, Gilbert EM. Left ventricular perforation after Impella® placement in a patient with cardiogenic shock. Catheter Cardiovasc Interv 2018; 91 (05) 894-896
- 3 Campeau L. Letter: Grading of angina pectoris. [Letter] Circulation 1976; 54 (03) 522-523
- 4 Glazier JJ, Kaki A. Left ventricular perforation after Impella placement. Catheter Cardiovasc Interv 2017; [Epub ahead of print] DOI: 10.1002/ccd.27451.
- 5 Abiomed Surpasses 50,000 Impella Patients Treated in the United States. Available at https://www.dicardiology.com/content/abiomed-surpasses-50000-impella-patients-treated-unitedstates . Accessed January 21, 2018