Push is better than Shove: Radial snare-guided repositioning of an extracardiac impella device

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Background: Bedside manipulation of an Impella CP is often necessary as subtle changes in device position after initial placement can dramatically affect proper function. Case presentation: A 59 year old man in cardiogenic shock on V-A ECMO support underwent Impella CP placement to function as an LV vent. Bedside manipulation led to the Impella dislodging into the ascending aorta and kinking in half. Percutaneous rescue was performed in the cardiac catheterization laboratory by snaring the device, and guiding it back into the LV in a controlled fashion restoring normal function. Conclusions: Bedside manipulation of an Impella is often necessary, but may cause device dislodgement. Re-entry into the LV is challenging and replacement of the device carries significant cost and clinical implications. Radial approach, snare guided repositioning offers an alternative solution to an increasingly encountered challenge.

Original languageEnglish (US)
JournalCardiovascular Revascularization Medicine
StateAccepted/In press - 2021

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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