Efficacy of intracardiac right ventricular microaxial pump support during beating heart surgery

To evaluate the safety and efficacy of a new developed intracardiac right ventricular microaxial pump (elect 300, Impella AG, Aachen) the intracardiac pump (IRVP) was applied to patients undergoing beating heart coronary surgery. To our knowledge, this is the first description of an intracardiac microaxial pump device inserted through the pulmonary artery into the right ventricle. Six patients undergoing coronary surgery for 3-vessel disease were operated on without extracorporeal circulation with the new IRVP device. During the procedure, cardiac output (CO), arterial blood pressure (MAP), central venous pressure (CVP), right ventricular pressure (RVP), pulmonary artery pressure (PAP) and left atrial pressure (LAP) were recorded. Placement of the IRVP was easy, quick and without significant blood loss. During the procedure, all devices worked well. Rhythm disturbances requiring therapeutic measures were not observed. Patients with beating heart surgery and IRVP support maintained CO (87 (73-116) % of baseline) and MAP (101 (69-126) % of baseline). After the Trendelenburg maneuver, CVP raised and RVP remained constant. PAP (150 (117-164) % of baseline) and LAP (290 (75-400) % of baseline) raised, indicating an effective blood transport out of the RV. Our results show that an IRVP can be applied safely and effectively in patients undergoing beating heart coronary surgery.