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Bertolin S, Maj G, Cavozza C, Cardinale A, Pullara A, Audo A, Pappalardo F. Impella 5.0/5.5 Implantation via Innominate Artery: Further Expanding the Opportunities for Temporary Mechanical Circulatory Support. J Clin Med 2022; 11:jcm11195917. [PMID: 36233784 PMCID: PMC9570778 DOI: 10.3390/jcm11195917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/04/2022] [Accepted: 10/06/2022] [Indexed: 11/16/2022] Open
Abstract
When axillary/subclavian arteries are not suitable because of size or anatomy, alternative access for the Impella pump 5.0/5.5 via the innominate artery allows circulatory support and eventually de-escalation from VA-ECMO to isolated left-side support. Moreover, less invasive surgery without the need to open the pericardium reduces the risk of RV dysfunction and bleeding. Finally, upper body strategies allow early rehabilitation during support, which is associated with improved survival in cardiogenic shock.
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Affiliation(s)
- Stephanie Bertolin
- Department of Cardiothoracic and Vascular Anesthesia and Intensive Care, AO SS Antonio e Biagio e Cesare Arrigo, Via Venezia, 16, 15121 Alessandria, Italy
- Correspondence: ; Tel.: +39-3408503947
| | - Giulia Maj
- Department of Cardiothoracic and Vascular Anesthesia and Intensive Care, AO SS Antonio e Biagio e Cesare Arrigo, Via Venezia, 16, 15121 Alessandria, Italy
| | - Corrado Cavozza
- Department of Cardiac Surgery, AO SS Antonio e Biagio e Cesare Arrigo, Via Venezia, 16, 15121 Alessandria, Italy
| | - Astrid Cardinale
- Department of Cardiothoracic and Vascular Anesthesia and Intensive Care, AO SS Antonio e Biagio e Cesare Arrigo, Via Venezia, 16, 15121 Alessandria, Italy
| | - Alberto Pullara
- Department of Cardiology, AO SS Antonio e Biagio e Cesare Arrigo, Via Venezia, 16, 15121 Alessandria, Italy
| | - Andrea Audo
- Department of Cardiac Surgery, AO SS Antonio e Biagio e Cesare Arrigo, Via Venezia, 16, 15121 Alessandria, Italy
| | - Federico Pappalardo
- Department of Cardiothoracic and Vascular Anesthesia and Intensive Care, AO SS Antonio e Biagio e Cesare Arrigo, Via Venezia, 16, 15121 Alessandria, Italy
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