Impella 2.5 Cardiac assist device

[Paseo Del Norte]

http://www.abiomed.com/products/impella.cfm

Is anybody utilising this device? I would love to hear first hand information about it, specifically any pearls regarding management and transport implications.

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[proman]

What are you looking for? My only experience with the Impella is when the patient had to go emergently for a real LVAD when the Impella failed. The ones that work here are in the CCU cared for by cardiologists.

I'm guessing not too many people here have experienced the misery of taking care of VADs.

 

[Paseo Del Norte]

We have a few people in my area with LVADS, the Heart Mate II is the flavour of the month here.

I guess I am just looking for any general information or advice about this device. If it is something that may become more popular, I would like to hear what the critical care docs have to say about it. It is not uncommon for my employer to receive calls for IABP and VAD transports (Typically destination and bridge to transplant patients.), therefore it is possible that we will run into this device if docs start using it.

 

[bluewater]

We use it at my joint. It is placed perc.(fem art) and inserted from the aorta through AV and into the LVOT. It functions as an axial flow device. I have seen it in heart failure both in the acute and chronic setting. There is a 5 lpm impella in the works.

Impella v IABP (in my opinion)
Impella generates greater CO by actualling moving a given volume of blood directly from the LV into the aorta
IABP generates greater CO, by increasing diastolic perfussion thereby improving oxygen delivery and allowing the LV to increase contractility, but the IABP also helps to off load the LV during deflation.

The early data would suggest greater bleeding associated with insertion and removal of the impella.