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Multimed Man Cardiothorac Surg ; 20202020 Dec 23.
Article in English | MEDLINE | ID: covidwho-1007098

ABSTRACT

We describe the insertion of the Impella 5.0, a peripherally placed mechanical cardiovascular microaxial pump, in a patient with ischemic left ventricular dysfunction. The Impella is a 7 Fr device capable of achieving a flow of 4.0-5.0 L/min; its use necessitates an open arterial cut-down. A subclavicular incision is used to access the right or left axillary artery. A 10-mm tube graft is anastomosed to the artery through which the Impella 5.0 is inserted. The device traverses the tube graft and is advanced via the aorta, across the aortic valve, to its final position (inflow toward the ventricular apex and outflow above the aorta). The device may remain in situ for 10 days until recovery or until further supports are instituted. Our goal is to demonstrate the insertion of the Impella 5.0 device in a patient with cardiogenic shock whose situation was further complicated by coronavirus disease 2019.


Subject(s)
Assisted Circulation , COVID-19 , Heart-Assist Devices , Prosthesis Implantation , ST Elevation Myocardial Infarction , Shock, Cardiogenic , Adult , Assisted Circulation/instrumentation , Assisted Circulation/methods , COVID-19/complications , COVID-19/therapy , Cardiac Catheterization/methods , Humans , Male , Prone Position/physiology , Prosthesis Implantation/instrumentation , Prosthesis Implantation/methods , SARS-CoV-2/isolation & purification , ST Elevation Myocardial Infarction/complications , ST Elevation Myocardial Infarction/physiopathology , Shock, Cardiogenic/etiology , Shock, Cardiogenic/physiopathology , Shock, Cardiogenic/surgery , Treatment Outcome
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