Temporary ventricular assist devices

Preoperative
management using Impella support for acute aortic dissection with left coronary malperfusion: a case report. Computed tomography scan. The ascending aorta is shown after dissection and dilatation to a maximum of 52 mm. The Impella CP™ is guided through the true lumen into the left ventricle (red arrow)
tehj.springeropen.com • CC-by-4.0
Pitfalls of
anesthetic management with the Impella® 5.0 device: a case series. a Mid-esophageal long-axis view of transesophageal echocardiography. Yellow arrow indicates Impella cannula and green arrow indicates artifacts. Precise identification of aortic insufficiency by transesophageal echocardiography was difficult because of reverberation artifacts associated with axial blood flow inside of Impella. b Deep transgastric view of transesophageal echocardiography. Red arrow indicates regurgitation jet in the left ventricle due to aortic insufficiency. It was clearly identified without artifacts on this view
jaclinicalreports.springeropen.com • CC-by-4.0
A case of
left ventricular free wall rupture after insertion of an IMPELLA® left ventricular assist device diagnosed by transesophageal echocardiography. Apical four chamber view (a) and apical long-axis view (b) by transthoracic echocardiography. Note the pericardial effusion (double arrow) and the abnormal flow on apex of the left ventricle (small arrow), part of the IMPELLA® (asterisk). The tip of the IMPELLA® is not depicted
jaclinicalreports.springeropen.com • CC-by-4.0
Radiopaedia • CC-by-nc-sa 3.0 • de

Temporary ventricular assist devices (or temporary VADs) are temporary percutaneous devices used in supporting a failing heart in cardiogenic shock or perioperatively.

Principle

Temporary VADs consist of an inlet, outlet and impeller pump all housed within a catheter. Temporary VADs are inserted percutaneously usually via the femoral artery. They are advanced retrograde until they overlie the aortic valve and project into the left ventricle. Blood is pumped from the left ventricle through the inlet via the impeller pump and then out into the aorta via the outlet. They usually remain in situ for 4-6 days . The most common type is the Impella family of devices.

Radiographic features

The tip of a left-sided temporary VAD should be located centrally over the left ventricle .

Complications

Complications that may arise from temporary VAD insertion and use include :

  • cardiac arrhythmias
  • ventricular perforation
  • aortic wall injury
  • pump thrombosis
  • device failure
  • device fracture 
  • stroke

Impella devices are unsafe with MRI .

See also

Siehe auch:
Assoziationen und Differentialdiagnosen zu Temporary ventricular assist devices:
Fremdmaterial
im Röntgenbild des Thorax
Wikipedia • CC BY-SA 3.0
mechanische
kreislaufunterstützende Devices bei akutem Herzversagen
insightsimaging.springeropen.com • CC-by-4.0