Cardiothoracic & vascular anesthesia
Crossing Boundaries: Utilizing Left-sided Impella for Right Ventricular Mechanical Support and Intraoperative Transesophageal Echocardiogram Considerations
Authors' conclusion
Left-sided Impella can be used to support the right ventricle in patients who have undergone surgical tricuspid valve procedures. It provides direct right ventricular unloading, does not cross a newly replaced or repaired tricuspid valve, and allows early ambulation.
Study context
- Population
- Patients with severe preoperative right ventricular failure undergoing surgical tricuspid valve procedures, single tertiary university hospital
- Participants
- 5 consecutive patients
- Outcome
- Early clinical course after RV support with left-sided Impella (extubation, ambulation, RV recovery/explant, death)
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
Extubated within the first 24 hours and ambulated with the Impella by postoperative day (POD) 3
4 patients
Sufficient RV recovery to allow Impella LD explant by POD 10
4 patients
Died due to septic shock with the RV assist device still in place
1 patient
Transitioned to comfort measures 29 days after Impella explant
1 patient
Observational data: associations, not effects.
Further findings
Death and comfort measures
- Died of septic shock with the right ventricular assist device in place
- 1
- Transitioned to comfort measures 29 days after Impella explant
- 1
Original publication
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