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 United Kingdom

First Page

469

Last Page

472

Document Type

Article

Publication Date

4-1-2024

Department

Surgery

Second Department

Medicine

Keywords

ECMO, hemostasis, impella, Intra-aortic balloon pump

Disciplines

Medicine and Health Sciences

Abstract

Background: 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. Results: 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. Conclusion: 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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