NYMC Faculty Publications

Escalation From Intra-Aortic Balloon Pump to Axillary Impella 5.5 Support: Staged Removal of the Femoral Access

Author Type(s)

Faculty

DOI

10.1177/02676591221147431

Journal Title

Perfusion

First Page

469

Last Page

472

Document Type

Article

Publication Date

4-1-2024

Department

Surgery

Second Department

Medicine

Abstract

With the growing population of advanced heart failure, the use of Impella 5.5 has been increasing. Here, we report an effective strategy of removing the intra-aortic balloon pump (IABP) in the setting of escalation of support to Impella 5.5. From January 1, 2022 to June 30, 2022, a total of 6 patients have undergone IABP removal during Impella 5.5 insertion. The IABP was subsequently removed over the long wire with manual compression on the femoral artery to control bleeding. An 8 or 9 Fr short sheath is inserted over the wire. Staged hemostasis was successfully performed in 4 patients, and the remaining two patients required escalation of support to veno-arterial membrane oxygenation as EC-PELLA utilizing the femoral arterial sheath. This does not only achieve secured hemostasis but also enables a smooth transition to further escalate support such as extracorporeal membrane oxygenation support, if necessary.

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