The Royal Papworth Hospital, Cambridge, United Kingdom.
Department of Transplantation Royal Papworth Hospital NHS Foundation Trust Cambridge, United Kingdom.
Multimed Man Cardiothorac Surg. 2020 Dec 23;2020. doi: 10.1510/mmcts.2020.078.
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.
我们描述了一位患有缺血性左心室功能障碍的患者插入 Impella 5.0 的过程。Impella 5.0 是一种外周放置的机械心血管微轴流泵，可实现 4.0-5.0 L/min 的流量；其使用需要进行动脉切开术。通过锁骨下切口进入右或左腋动脉。将 10 毫米的管型移植物与动脉吻合，Impella 5.0 通过该动脉插入。该设备穿过管型移植物，通过主动脉推进，穿过主动脉瓣，到达最终位置（流入心室顶点，流出主动脉上方）。该设备可以在原位停留 10 天，直到恢复或直到进一步的支持措施建立。我们的目标是展示一位患有心源性休克的患者插入 Impella 5.0 设备的过程，该患者的情况因 2019 年冠状病毒病而进一步复杂化。
