First Experience With Implantation of a Percutaneous Right Ventricular Impella Right Side Percutaneous Support Device as a Bridge to Recovery in Acute Right Ventricular Infarction Complicated by Cardiogenic Shock in the United States

Margey, Ronan; Chamakura, Sanjay; Siddiqi, Saadi; Senapathi, Murali; Schilling, Josh; Fram, Daniel B.; Hirst, Jeffrey A.; Saddiq, Immad; Silverman, David I.; Kiernan, Francis J.

doi:10.1161/circinterventions.113.000283

Cited by 21 publications

(9 citation statements)

References 4 publications

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“…First reported by Margey et al , the Impella RP is a minimally invasive RVAD that has been developed particularly to assist the failing right heart. The FDA‐approved Impella RP system is composed of a microaxial pump including a drive motor and an impeller (Fig.…”

Section: Discussionmentioning

confidence: 99%

“…The TandemHeart ® (CardiacAssist, Pittsburgh, PA), a centrifugal flow pump, has been used for right‐sided support with an inflow cannula placed in the right atrium (RA) and an outflow cannula in the main pulmonary artery (PA) with one (if not both) of these via femoral venous access . The Impella RP (Abiomed, Danvers, MA), an axial flow pump, has also been developed for right‐sided support and is also inserted via femoral access .…”

Section: Introductionmentioning

confidence: 99%

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Current status of percutaneous right ventricular assist devices: First‐in‐man use of a novel dual lumen cannula

Aggarwal

Einhorn

Cohen

2016

Cathet Cardio Intervent

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Ventricular assist devices have become an accepted therapeutic solution for patients with severe left ventricular dysfunction when pharmacology fails to maintain sufficient cardiac output. Despite various technologies that have allowed left ventricular assist devices to become more reliable and versatile in the past decade, comparatively little attention has been applied to right heart assistance which is still in the early stage of its development. The extracorporeal devices developed thus far have been associated with mobility issues and complications common to ventricular assist devices in general, such as infection, bleeding, and thromboembolism. Designed to obviate the problems previously experienced by other right ventricle (RV)-focused devices, the Protek Duo (CardiacAssist, Pittsburgh, PA) is a novel, fully percutaneous, dual lumen cannula for RV support used in conjunction with the paracorporeal TandemHeart(®) (CardiacAssist, Pittsburgh, PA) pump. We describe our initial experience with the Protek Duo cannula in two different clinical scenarios. In addition, we summarize the current percutaneous mechanical support technology for RV assistance and propose modification of current technology to facilitate its application. © 2016 Wiley Periodicals, Inc.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Current status of percutaneous right ventricular assist devices: First‐in‐man use of a novel dual lumen cannula

Aggarwal

Einhorn

Cohen

2016

Cathet Cardio Intervent

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“…Successful application of the Impella RP in four RHF patients has been reported. 27,2829 The results of the recently finished Canadian/European clinical trial was presented at the 2012 American College of Cardiology meeting, 30 but the data has not been formally published yet. A U.S. clinical trial is currently ongoing to test the Impella RP device.…”

Section: Discussionmentioning

confidence: 99%

Development of a Double-Lumen Cannula for a Percutaneous RVAD

et al. 2015

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The objectives were to design/fabricate a double lumen cannula (DLC) for a percutaneous RVAD (pRVAD), and to test the feasibility/performance of this pRVAD system. A 27 Fr DLC prototype was made and tested in 6 adult sheep. The pRVAD DLC was inserted into the right jugular vein, advanced through the superior vena cava (SVC)-right atrium (RA)-right ventricle (RV), and ended in the pulmonary artery (PA). A CentriMag pump and optional gas exchanger were connected to the DLC. Blood was withdrawn from RA, pumped through gas exchanger, and perfused PA. Maximal pumping flow was maintained for 2 hours. The pRVAD DLC was successfully deployed in all 6 sheep. In first 3 sheep, maximal average pumping flow was below 3 l/min because the DLC was advanced too far with drainage opening against RA side wall. In last 3 sheep with well positioned DLC, average maximal flow was above 3.5 l/min. The gas exchanger provided up to 230 ml/min CO2 removal and 174 ml/min O2 transfer. Our DLC-based pRVAD system is feasible for percutaneous right heart and respiratory assistance through a single cannulation. The pRVAD DLC can easily be placed prophylactically during LVAD implantation and removed as needed without additional open chest procedures.

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“…One of these is the Impella RP, which is a percutaeneous device that has FDA approval for Humanitarian Device Exemption for implantation of up to 14 days in patients with acute right heart failure. It is the first axial flow catheter designed to support the RV 98 99. The RECOVER RIGHT trial was recently published and confirmed the haemodynamic efficacy and safety of the Impella RP 99.…”

Section: Future Perspectivesmentioning

confidence: 98%

Percutaneous mechanical circulatory support: current concepts and future directions

Briceno

Kapur

Perera

2016

Heart

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First Experience With Implantation of a Percutaneous Right Ventricular Impella Right Side Percutaneous Support Device as a Bridge to Recovery in Acute Right Ventricular Infarction Complicated by Cardiogenic Shock in the United States

Cited by 21 publications

References 4 publications

Current status of percutaneous right ventricular assist devices: First‐in‐man use of a novel dual lumen cannula

Current status of percutaneous right ventricular assist devices: First‐in‐man use of a novel dual lumen cannula

Development of a Double-Lumen Cannula for a Percutaneous RVAD

Percutaneous mechanical circulatory support: current concepts and future directions

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