Key result
Epicardial echocardiography successfully guided the implantation of the Impella CP device in all 14 ovine models, demonstrating its feasibility as an intraoperative imaging alternative.
Why the study?
Fluoroscopy for Impella insertion limits placement to catheterization laboratories, and existing echocardiographic guidance techniques face specific surgical, anatomical, and equipment limitations.
Epicardial echocardiography is a feasible and practical intraoperative imaging modality for guiding Impella CP implantation in ovine models, offering a viable alternative when fluoroscopy or transesophageal echocardiography is unavailable.
Animal feasibility data support exploring epicardial echo guidance for Impella; leaves open human translation.
The Impella CP is a percutaneously inserted temporary left ventricular assist device used in clinical practice and in translational research into cardiogenic shock, perioperative cardiac surgery, acute cardiac failure and mechanical circulatory support. Fluoroscopic guidance is usually used for insertion of an Impella, thus limiting insertion to within catheterization laboratories. Transthoracic, transoesophageal and intracardiac echocardiography have been reported to guide Impella CP implantation with identified specific limitations stemming from the surgical, anatomical and equipment factors. We conducted translational prospective descriptive feasibility investigation as a part of two other hemodynamic Impella studies. It showed the successful application of epicardial echocardiographic scanning for implantation of Impella CP devices in ovine models, from which details of the technique and identified pitfalls are described with practical solutions for future investigators and clinicians. Many described findings are relevant to any other echocardiographic techniques when adequate imaging of the Impella and relevant anatomical structures is achievable.
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Yastrebov et al. (2024) studied Animal model for Impella CP implantation (n=14). Epicardial echocardiography guidance was evaluated on Successful implantation of Impella CP under epicardial echocardiographic guidance. Epicardial echocardiography successfully guided the implantation of the Impella CP device in all 14 ovine models, demonstrating its feasibility as an intraoperative imaging alternative.
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