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Initial Experience With the Pediatric I mpella Device: A Feasibility Study in a Porcine Model
Author(s) -
Webb Melissa K.,
Wang Jian,
Riegel Matthew S.,
Guleserian Kristine J.,
Forbess Joseph M.,
Zellers Thomas M.,
Dimas V. Vivian
Publication year - 2016
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.26583
Subject(s) - medicine , impella , circulatory system , carotid arteries , implant , ultrasound , cardiology , ventricular assist device , right common carotid artery , catheter , common carotid artery , surgery , radiology , heart failure
Objective This study's objective was to evaluate insertion techniques and device fit of the pediatric version of the Impella ventricular assist device in swine which had similar sized carotids and left ventricles (LVs) as children weighing 10–20 kg. Background Options for minimally invasive circulatory support in children are limited. A modified device based on the current Impella 2.5 platform was created in an effort to provide minimally invasive circulatory support for children. Methods Animal studies ( n = 10) were performed to determine technical feasibility of device implant via the right common carotid artery (RCCA) in swine with a carotid and LV size similar to children with a BSA < 1 m 2 and weight 10‐20 kg. The RCCA diameter was measured on pre‐implant ultrasound and the LV length was measured at necropsy. The animals were supported for 4 hr and the device explanted. Blood samples and post‐explant necropsy was performed to evaluate for device related complications. Results All animals underwent successful device insertion. Mean carotid artery diameter by ultrasound was 3.5 ± 0.3 mm. There was no LV or aortic/mitral valve damage with a minimum LV length of 5.4 cm. Conclusions Minimally invasive circulatory support is needed in small children. Limitations are primarily related to vessel and chamber size. The Impella Pediatric catheter was safely and successfully implanted in carotid arteries similar in size to children weighing 10–20 kg with minimal complications. © 2016 Wiley Periodicals, Inc.