Single arterial access for Ecpella and jugular venous cannulation provides full mobility on a status 1 heart transplant recipient

Bitargil, Macit; Pham, Si M.; Haddad, Osama; Sareyyüpoğlu, Başar

doi:10.1002/ehf2.13862

Cited by 10 publications

(7 citation statements)

References 7 publications

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“…This can explain the superiority of smaller VADs for early extubation, better pain management, absence of adhesions in the mediastinum, and gentle explantation process during HTx. The majority of our Impella patients participated in active physical therapy 32 ( Figure ). The transplant procedure itself ran a less complicated course in comparison with an LVAD explant surgery; all patients had their chest closed during HTx.…”

Section: Discussionmentioning

confidence: 99%

Short‐term outcomes of heart transplant patients bridged with Impella 5.5 ventricular assist device

et al. 2023

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Aims We sought to investigate the outcomes of heart transplant patients supported with Impella 5.5 temporary mechanical circulatory support. Methods and results Patient demographics, perioperative data, hospital timeline, and haemodynamic parameters were followed during initial admission, Impella support, and post‐transplant period. Vasoactive‐inotropic score, primary graft failure, and complications were recorded. Between March 2020 and March 2021, 16 advanced heart failure patients underwent Impella 5.5 temporary left ventricular assist device support through axillary approach. Subsequently, all these patients had heart transplantation. All patients were either ambulatory or chair bound during their temporary mechanical circulatory support until heart transplantation. Patients were kept on Impella support median of 19 days (3–31) with the median lactate dehydrogenase level of 220 (149–430). All Impella devices were removed during heart transplantation. During Impella support, patients had improved renal function with median creatinine serum level of 1.55 mg/dL decreased to 1.25 (P = 0.007), pulmonary artery pulsatility index scores increased from 2.56 (0.86–10) to 4.2 (1.3–10) (P = 0.048), and right ventricular function improved (P = 0.003). Patients maintained improved renal function and favourable haemodynamics after their heart transplantation as well. All patients survived without any significant morbidity after their heart transplantation. Conclusions Impella 5.5 temporary left ventricular assist device optimizes care of heart transplant recipients providing superior haemodynamic support, mobility, improved renal function, pulmonary haemodynamics, and right ventricular function. Utilizing Impella 5.5 as a direct bridging strategy to heart transplantation resulted in excellent outcomes.

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Section: Discussionmentioning

confidence: 99%

Short‐term outcomes of heart transplant patients bridged with Impella 5.5 ventricular assist device

et al. 2023

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“…However, an innovative method to introduce both the Impella and arterial ECMO cannula through the same arterial access site has been successfully described. 36 Management of ECPELLA (the concomitant use of both VA ECMO and Impella) is challenging. While VA ECMO is used to provide end-organ perfusion and oxygen delivery, Impella is introduced to reduce LV filling pressure.…”

Section: Ecpellamentioning

confidence: 99%

“…However, an innovative method to introduce both the Impella and arterial ECMO cannula through the same arterial access site has been successfully described. 36 …”

Section: Ecpellamentioning

confidence: 99%

What the pediatric nurse needs to know about the Impella cardiac assist device

Borrelli,

Nittolo,

Bochicchio

et al. 2024

Perfusion

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Background: Cardiogenic shock in children still carries a high mortality risk despite advances in medical therapy. The use of temporary mechanical circulatory supports is an accepted strategy to bridge patients with acute heart failure to recovery, decision, transplantation or destination therapy. These devices are however limited in children and extracorporeal membrane oxygenation (ECMO) remains the most commonly used device. Veno-arterial ECMO may provide adequate oxygen delivery, but it does not significantly unload the left ventricle, and this may prevent recovery. To improve the likelihood of left ventricular recovery and minimize the invasiveness of mechanical support, the Impella axial pump has been increasingly used in children with acute heart failure in the last decade. Purpose: There are still limited data describing the Impella indications, management and outcomes in children, therefore, we aimed to provide a comprehensive narrative review useful for the pediatric nurses to be adequately trained and acquire specific competencies in Impella management.

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“…Further improvement of the single-site ECMELLA approach is the ECMELLA 2.1 technique, with the percutaneous cannulation of the jugular vein for blood drainage. This approach allows patients' mobilization on ongoing support for an extended period of time (Table 1) [17].…”

Section: Ecmella Approachmentioning

confidence: 99%

“…ECMELLA allows a controlled stepwise support reduction and de-escalation strategy: v-a ECLS explantation with further Impella support, which achieves a reduction of ECLS-related complications in patients requiring prolonged support [1]. The recently developed single arterial access ECMELLA 2.1 includes advantages of high flow support, patients' mobilization, and bedside explantation, with no need for a renewed exploration of the implantation site [13,15,17].…”

Section: • Complication Profile • Availability Of Each System and Costsmentioning

confidence: 99%

Left Ventricular Unloading in v-a ECLS Patients

Nersesian¹,

Lewin²,

Lanmüller³

et al. 2023

Extracorporeal Membrane Oxygenation Support Therapy

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The v-a ECLS is an effective approach for mechanical circulatory support, however, it is associated with several disadvantages. An increased afterload generated by a pump outflow leads to a left ventricular (LV) distension, pulmonary congestion, and lung edema on one hand and impairs myocardial perfusion on the other. In this chapter, we will discuss the rationality as well as different techniques for LV unloading during v-a ECLS support.

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Single arterial access for Ecpella and jugular venous cannulation provides full mobility on a status 1 heart transplant recipient

Cited by 10 publications

References 7 publications

Short‐term outcomes of heart transplant patients bridged with Impella 5.5 ventricular assist device

Short‐term outcomes of heart transplant patients bridged with Impella 5.5 ventricular assist device

What the pediatric nurse needs to know about the Impella cardiac assist device

Left Ventricular Unloading in v-a ECLS Patients

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