Shimizu Miho, Hiraiwa Hiroaki, Tanaka Shinya, Tsuchikawa Yohei, Ito Ryota, Kazama Shingo, Kimura Yuki, Araki Takashi, Mizutani Takashi, Oishi Hideo, Kuwayama Tasuku, Kondo Toru, Morimoto Ryota, Okumura Takahiro, Ito Hideki, Yoshizumi Tomo, Mutsuga Masato, Usui Akihiko, Murohara Toyoaki
Department of Rehabilitation, Nagoya University Hospital, Nagoya 466-8560, Japan.
Department of Rehabilitation, Mie University Hospital, Tsu 514-8507, Japan.
J Pers Med. 2023 Apr 3;13(4):630. doi: 10.3390/jpm13040630.
Impella 5.0 circulatory support via subclavian artery (SA) access may be a safe approach for patients undergoing cardiac rehabilitation (CR). In this case series, we retrospectively analyzed the demographic characteristics, physical function, and CR data of six patients who underwent Impella 5.0 implantation via the SA prior to left ventricular assist device (LVAD) implantation between October 2013 and June 2021. The median age was 48 years, and one patient was female. Grip strength was maintained or increased in all patients before LVAD implantation (pre-LVAD) compared to after Impella 5.0 implantation. The pre-LVAD knee extension isometric strength (KEIS) was less than 0.46 kgf/kg in two patients and more than 0.46 kgf/kg in three patients (unavailable KEIS data, = 1). With Impella 5.0 implantation, two patients could ambulate, one could stand, two could sit on the edge of the bed, and one remained in bed. One patient lost consciousness during CR due to decreased Impella flow. There were no other serious adverse events. Impella 5.0 implantation via the SA allows mobilization, including ambulation, prior to LVAD implantation, and CR can be performed relatively safely.
经锁骨下动脉（SA）通路使用Impella 5.0进行循环支持对于接受心脏康复（CR）的患者可能是一种安全的方法。在本病例系列中，我们回顾性分析了2013年10月至2021年6月期间在植入左心室辅助装置（LVAD）之前通过SA植入Impella 5.0的6例患者的人口统计学特征、身体功能和CR数据。中位年龄为48岁，1例为女性。与Impella 5.0植入后相比，所有患者在LVAD植入前（LVAD前）的握力保持或增加。LVAD前，2例患者的膝关节伸展等长力量（KEIS）小于0.46 kgf/kg，3例患者大于0.46 kgf/kg（KEIS数据不可用，1例）。随着Impella 5.0的植入，2例患者可以行走，1例可以站立，2例可以坐在床边，1例仍卧床。1例患者在CR期间因Impella血流减少而失去意识。没有其他严重不良事件。通过SA植入Impella 5.0可在LVAD植入前实现包括行走在内的活动能力，并且可以相对安全地进行CR。
