Impella

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Impella is a cardiac support system from Abiomed. It is used to support the left and (more rarely) right halves of the heart during cardiogenic shock .

principle

The Impella is a very small axial pump that is advanced to the heart via an arterial vessel (often the femoral artery ). There it comes to lie in such a way that the blood in the left ventricle is taken up by the pump and is pumped into the ascending aorta . This improves circulatory function and reduces the load on the left ventricle. This is where the Impella differs from veno-arterial- extracorporeal membrane oxygenation , in which the afterload for the left ventricle is increased. The system is available in three different sizes and can generate a blood flow of 2.5 l / min to 5 l / min.

With the Impella RP there is also a variant to support the right ventricle. The blood is taken up in the inferior vena cava and pumped into the pulmonary artery .

commitment

The main area of ​​application of the Impella is cardiogenic shock, caused for example by a heart attack , terminal heart failure , myocarditis , stress cardiomyopathy , peripartal cardiomyopathy or postcardiotomy syndrome after cardiac surgery. Depending on the cause of the shock, the therapy goal is to bridge the period until the heart has recovered ("bridge-to-recovery") or to gain time until the therapy decision ("bridge-to-decision"), for example for a permanent cardiac support system or a heart transplant

Impella pumps are also used as a precautionary measure during coronary interventions as part of a cardiac catheter examination in patients with a high risk of complications during the procedure. This procedure is called "Protected PCI".

Individual evidence

  1. ↑ a b Clinical scenarios for use of transvalvular microaxial pumps in acute heart failure and cardiogenic shock - A European experienced users working group opinion. Int J Cardiol. 2019 Sep 15; 291: 96-104.
  2. ↑ a b Expert consensus on the practical use of cardiovascular support systems in high-risk coronary interventions. Retrieved April 13, 2020 .
  3. ↑ Abiomed Impella RP. Retrieved April 13, 2020 .

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