Impella percutaneous left ventricular assist device

Impella percutaneous left ventricular assist device

Impella percutaneous left ventricular assist device: Impella LP 2.5 manufactured by Abiomed-Impella CardioSystems GmbH, Aachen, Germany is percutaneous left ventricular assist device. It uses a catheter-based miniaturized rotary blood pump, that is placed retrogradely through the aortic valve. The microaxial pump aspirates blood from the left ventricle and expels it to the ascending aorta with a maximal flow of 2.5 L/min. It may be used to tide over a crisis situation in patients with cardiogenic shock of reversible etiology. Efficacy Study of LV Assist Device to Treat Patients With Cardiogenic Shock (ISAR-SHOCK) using this device has been completed. It was a comparison between in intra aortic balloon pump (IABP) and Impella LP 2.5 left ventricular assist device in acute coronary syndrome with cardiogenic shock. A report of the trial in the November 4, 2008 issue of JACC [1] mentions that the cardiac index (CI) after 30 minutes of support was significantly increased in patients with the Impella LP2.5 compared with patients with IABP (Impella: CI = 0.49 ± 0.46 l/min/m2; IABP: CI = 0.11 ± 0.31 l/min/m2; p = 0.02). Mortality benefit has not been demonstrated yet [2].

Recover® LP 2.5 is a minimally invasive ventricular unloading catheter which can introduced percutaneously through the femoral artery and provides a flow of 2.5 litres per minute. Recover® LP 5.0 is a ventricular unloading catheter, which is placed via a femoral artery cut-down into the left ventricle and can support a flow of 5 litres per minute.

References

1. Melchior Seyfarth, Dirk Sibbing, Iris Bauer, Georg Fröhlich, Lorenz Bott-Flügel, Robert Byrne, Josef Dirschinger, Adnan Kastrati, Albert Schömig. A randomized clinical trial to evaluate the safety and efficacy of a percutaneous left ventricular assist device versus intra-aortic balloon pumping for treatment of cardiogenic shock caused by myocardial infarction. J Am Coll Cardiol. 2008 Nov 4;52(19):1584-8.
2. Health Quality Ontario. Percutaneous Ventricular Assist Devices: A Health Technology Assessment. Ont Health Technol Assess Ser. 2017 Feb 7;17(2):1-97. eCollection 2017.