Impella Basics
This Impella device provides left ventricular support and is most commonly inserted via the femoral artery.
What is the Impella CP?
This alarm suggests the pump has migrated too far into the ventricle.
What is Impella in Ventricle?
This chamber benefits from unloading during complex PCI.
What is the left ventricle?
The Danger RCT compared
What is Compared standard of care to Impella + standard of care
Before dilator is removed and Impella inserted, this coagulation target should be reached.
What is an ACT of 250 or higher?
The recommended minimum P-level during weaning before explant.
What is P-2?
This alarm suggests the pump has pulled back so the inlet is no longer across the aortic valve.
What is Impella in Aorta?
This catheter helps assess filling pressures, cardiac output, and PAPi in shock patients.
What is Swan-Ganz catheter?
What was the overall increase in survival for patients in the impella arm of the Danger Trial?
What is 12.7% increase in survival?
During CP insertion, this technique allows PCI through the Impella sheath.
What is Single access?
This chamber is unloaded by the RP flex.
What is the right ventricle?
This alarm occurs when the inlet is no longer adequately surrounded by blood and ventricular preload may be low.
What is suction?
This hemodynamic index is commonly used to assess RV function
What is PAPi (Pulmonary Artery Pulsatility Index)
What is the number needed to treat (NNT) for patients under 77 years of age?
What is 0.018 V18 or Platinum plus?
A patient is aggressively diuresed prior to their cath lab procedure. The most likely cause for suction is inadequate...
What is preload?
When troubleshooting suction alarms, these are the first two things you should evaluate.
You place an Impella CP in a RCA STEMI patient but are unable to flow higher than 1.5 Lpm. A swan is placed showing a CVP of 25 mmHg which may indicate this problem.
What is right ventricular failure.
How many patients remained on a form of HD after 6 months?
What is 0 patients?
During insertion, crossing this structure is required before final positioning.
What is aortic valve?
The RP flex is inserted through this size sheath.
What is 23 Fr?
A patient develops recurrent suction alarms despite adequate fluid status. Echocardiography reveals a nearly empty LV. This indicated the patient may need less support, more support, or reassessment of this clinical factor.
What is right ventricular failure?
Cardiac power output is calculated this way, and this value predicts mortality.
What is MAP x CO / 451, with CPO <0.6 W?
After the RCT Danger study ACC/AHA Guidelines changed Impella to this and IABP/ECMO to this.
What is Class 2a recommendation - In selected patients with STEMI and severe or refractory cardiogenic shock insertion of a micoaxial flow pump is reasonable to reduce death.
IABP and VA ECMO Downgraded to Class 3 - Routine use is not recommonded due to lack of survival benefit.
Having these available before insertion help prepare for closure and post-procedure management.
What is vascular closure devices?