Monitored Anesthesia Care for Axillary Impella 5.5 Placement: A Feasible Option for Patients With Severe Cardiogenic Shock With Relative Contraindication to Intubation.
Manoj H IyerNicolas KumarErica SteinBryan A WhitsonMichael K EssandohPublished in: Seminars in cardiothoracic and vascular anesthesia (2023)
The Impella 5.5 left ventricular assist device (LVAD) is typically placed in a hybrid operating room with fluoroscopic and echocardiographic guidance under general anesthesia. In this case report, we describe a patient with severe cardiopulmonary failure necessitating an Impella 5.5 as a bridge to heart/lung transplant. Here, we describe the successful placement of the Impella 5.5 with sedation and local anesthesia in order to avoid general anesthesia and the sequelae of positive pressure ventilation in a fragile patient. Impella placement was confirmed with transesophageal echocardiography. This case report demonstrates a novel strategy for placing the Impella 5.5 and, more importantly, opens the possibility to future prospective studies of this technique.
Keyphrases
- left ventricular assist device
- case report
- ultrasound guided
- extracorporeal membrane oxygenation
- left ventricular
- pulmonary hypertension
- healthcare
- early onset
- computed tomography
- squamous cell carcinoma
- mitral valve
- lymph node
- radiation therapy
- mechanical ventilation
- quality improvement
- early stage
- intensive care unit
- current status
- chronic pain
- pain management
- sentinel lymph node
- locally advanced