1. Escalation from intra-aortic balloon pump to axillary impella 5.5 support: Staged removal of the femoral access.
- Author
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Sosa, Carlos Vazquez, Ohira, Suguru, Ahmad, Hasan, Isath, Ameesh, De La Pena, Corazon, Spielvogel, David, and Kai, Masashi
- Subjects
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EXTRACORPOREAL membrane oxygenation , *INTRA-aortic balloon counterpulsation , *HEART assist devices , *CATHETERIZATION , *MEDICAL device removal , *RETROSPECTIVE studies , *HEART failure , *HEMATOMA , *TREATMENT effectiveness , *GROIN , *SURGICAL hemostasis , *COMPRESSION therapy , *DISEASE complications , *CASE studies , *FEMORAL artery , *FLUOROSCOPY - 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. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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