Pitfalls of anesthetic management with the Impella® 5.0 device: a case series
| Autor: | Yoshihiko Ohnishi, Kenji Yoshitani, Naoshi Hotta, Akito Tsukinaga |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Percutaneous medicine.medical_treatment Case Report Heart failure lcsh:RD78.3-87.3 03 medical and health sciences 0302 clinical medicine 030202 anesthesiology Internal medicine medicine Extracorporeal membrane oxygenation Advanced medical care Impella business.industry Percutaneous ventricular assist device lcsh:Medical emergencies. Critical care. Intensive care. First aid 030208 emergency & critical care medicine lcsh:RC86-88.9 medicine.disease Catheter Anesthesiology and Pain Medicine medicine.anatomical_structure lcsh:Anesthesiology Ventricle Ventricular assist device Circulatory system Cardiology business |
| Zdroj: | JA Clinical Reports, Vol 6, Iss 1, Pp 1-5 (2020) JA Clinical Reports |
| ISSN: | 2363-9024 |
| Popis: | Background Impella® is an antegrade left ventricular assist device with a pump catheter in the left ventricle. We report three cases in which we experienced some pitfalls with circulatory management during Impella placement due to new-onset aortic insufficiency (AI) associated with device placement or the limited maximum flow rate. Case presentation Three patients developed new-onset AI due to Impella placement. In a patient, the total assisted flow rate was relatively low because of his large body size. In the other patients, in whom the Impella device was used in combination with percutaneous cardiopulmonary support or venoarterial extracorporeal membrane oxygenation (ECMELLA), total flow was maintained at a sufficient level. Conclusions New-onset of AI after Impella placement and its limited flow rate are considered to be pitfalls in circulatory management. Management with ECMELLA is considered to be effective during the acute phase when patients have decreased cardiac function. |
| Databáze: | OpenAIRE |
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