What are the contraindications for Impella?

What are the contraindications for Impella?

Contraindications to Impella usage include mechanical aortic valve or LV thrombus, ventricular septal defect, and severe peripheral arterial disease; relative contraindications include aortic stenosis and regurgitation.

When using the Impella 5.5 with Smart Assist catheter How often should the reference cardiac output be entered into the Impella console?

This Impella skills video demonstrates how to enter cardiac output into the Automated Impella Controller™ (AIC) for Impella CP® with SmartAssist® and Impella 5.5® with SmartAssist®. The AIC continuously calculates cardiac output (CO) and cardiac power output (CPO) but requires a CO value to be entered every 8 hours.

What is Impella placement signal?

Proper positioning of the Impella 2.5 and Impella CP can be verified by two waveforms called the placement signal (red) and motor current (green). The placement signal displays pressure (in millimeters mercury) throughout the cardiac cycle generated from an open pressure area.

What is Impella P level?

Impella Flow displays the additional amount of flow the patient is receiving. The large number displays the average amount of flow at the current P-level. Because the native heart is also providing flow, the fraction to the left of this number displays the max flow over the min flow during the cardiac cycle.

What is the difference between Impella 2.5 and CP?

The new Impella CP device was designed to provide a higher level of support than Impella 2.5. The safety and efficacy of this device have not yet been established for prolonged use.

What does the Impella 5.5 do?

It is a microaxial, surgically implanted heart pump that unloads the left ventricle, reduces ventricular work, and provides the circulatory support necessary to allow recovery and early assessment of residual myocardial function.

When did Impella 5.5 come out?

The Impella® 5.5 (Abiomed, Danvers, MA) percutaneous temporary left ventricular assist device (pVAD 5.5) received Food and Drug Administration pre‐market approval in September 2019.

How does Impella calculate cardiac output?

Cardiac power output (CPO) is the product of mean arterial pressure (MAP) and cardiac output (CO), CPO = MAP x CO/451, measured in watts (W) and is a measure of tissue perfusion.

What is Impella purge pressure?

The Impella heart pumps require a specific purge pressure range (300-1100 mm Hg) for optimal pump flow and a specific systemic ACT anticoagulation range (160-180 seconds) for optimal and sustained function. Studies report aPTT targets ranging between 55 and 80 seconds with optimal outcomes.

How long can Impella stay in?

The Impella was successfully inserted in all cases with a median duration of support of 70 minutes (range, 4 – 5760 minutes).

What does Impella 5.5 do?

Do you need heparin with Impella?

Heparin is the only anticoagulant approved by the FDA for use in the Impella purge solution. If a patient is intolerant to heparin, due to heparin-induced thrombocytopenia (HIT), it is recommended to utilize an anticoagulant free purge solution and continue an alternative systemic anticoagulant.

How many liters per minute does the heart pump?

What is a normal cardiac output? A healthy heart with a normal cardiac output pumps about 5 to 6 litres of blood every minute when a person is resting.

What is the maximum cardiac output?

Resting cardiac output in both trained and sedentary individuals is approximately 4 to 5 L/min, but during exercise the maximal cardiac output can reach 20 L/min.

How long can Impella be used?

It is designed to provide haemodynamic support for up to 30 days. Like the Impella 5.0, the Impella 5.5 device is an axial flow transaortic cardiac support device mounted on a 9 Fr steering catheter with a 21 Fr pump cannula.

What does Impella stand for?

Impella (Abiomed, Danvers, MA) is a percutaneously inserted ventricular assist device (VAD). It has been increasingly used in patients with severe heart failure, cardiogenic shock, and high-risk percutaneous intervention (PCI).

Do you need anticoagulation with Impella?

The Impella heart pumps require a specific purge pressure range (300-1100 mm Hg) for optimal pump flow and a specific systemic ACT anticoagulation range (160-180 seconds) for optimal and sustained function.