Escalation from intra-aortic balloon pump to axillary impella 5.5 support: Staged removal of the femoral access.
Carlos Vazquez SosaSuguru OhiraHasan AhmadAmeesh IsathCorazon De La PenaDavid SpielvogelMasashi KaiPublished in: Perfusion (2022)
Background: With the growing population of advanced heart failure, the use of Impella 5.5 has been increasing. Here, we report an effective strategy of removing the intra-aortic balloon pump (IABP) in the setting of escalation of support to Impella 5.5. Results: From January 1, 2022 to June 30, 2022, a total of 6 patients have undergone IABP removal during Impella 5.5 insertion. The IABP was subsequently removed over the long wire with manual compression on the femoral artery to control bleeding. An 8 or 9 Fr short sheath is inserted over the wire. Staged hemostasis was successfully performed in 4 patients, and the remaining two patients required escalation of support to veno-arterial membrane oxygenation as EC-PELLA utilizing the femoral arterial sheath. Conclusion: This does not only achieve secured hemostasis but also enables a smooth transition to further escalate support such as extracorporeal membrane oxygenation support, if necessary.
Keyphrases
- extracorporeal membrane oxygenation
- end stage renal disease
- heart failure
- ejection fraction
- newly diagnosed
- acute respiratory distress syndrome
- chronic kidney disease
- peritoneal dialysis
- left ventricular
- lymph node
- atrial fibrillation
- radiation therapy
- open label
- squamous cell carcinoma
- aortic valve
- pulmonary artery
- pulmonary arterial hypertension
- rectal cancer
- cardiac resynchronization therapy
- patient reported