Key result
Novel double device technique enables uninterrupted Impella CP to Impella 5.5 exchange without hemodynamic disarrangement.
Why the study?
Does a double device technique prevent hemodynamic disarrangement during the upgrade from Impella CP to Impella 5.5 in patients with minimal left ventricular reserve?
Case Report
Does a double device technique prevent hemodynamic disarrangement during the upgrade from Impella CP to Impella 5.5 in patients with minimal left ventricular reserve?
A novel double device technique enables uninterrupted mechanical circulatory support during the upgrade from Impella CP to Impella 5.5, avoiding hemodynamic instability.
May enable continuous Impella support during upgrades in select cases; hypothesis-generating and requires prospective validation before wider use.
For the first time, we present a novel technique that enables the exchange of the Impella CP (Abiomed Inc., Danvers, Massachusetts, USA) to the Impella 5.5 (Abiomed Inc.) with no interruption of mechanical support in patients with minimal left ventricular reserve. Specifically, the aortic valve is crossed with the Impella 5.5 whereas the Impella CP is still functioning within the left ventricle. The Impella 5.5 is then initiated, and the Impella CP is weaned. Finally, the Impella CP is pulled out into the descending aorta. This exchange provides continuous support with no hemodynamic disarrangement.
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Armas et al. (2021) conducted a case report in Minimal left ventricular reserve requiring mechanical support. Double device technique for uninterrupted upgrade from Impella CP to Impella 5.5 was evaluated on Hemodynamic disarrangement during exchange. A novel double device technique enables the uninterrupted exchange of Impella CP to Impella 5.5, providing continuous mechanical support with no hemodynamic disarrangement.
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