Open AccessUse of Tissue Plasminogen Activator Alteplase Purge Solution in an Impella 5.5 Heart Pump
Author(s) -
Robert Tunney,
William P. Tidwell,
Anupam Kumar,
D. Marshall Brinkley
Publication year - 2021
Publication title -
asaio journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.961
H-Index - 66
eISSN - 1538-943X
pISSN - 1058-2916
DOI - 10.1097/mat.0000000000001349
Subject(s) - purge , impella , cardiogenic shock , tissue plasminogen activator , heart transplantation , medicine , cardiology , transplantation , myocardial infarction , waste management , engineering
Standardized Impella purge solutions have traditionally consisted of 5-40% dextrose with or without unfractionated heparin as a means of anticoagulation. Such a solution serves to create a pressure barrier preventing entry of blood into the pump's motor housing with heparin providing adequate purge pathway patency in the event of this occurring. We present a case of tissue plasminogen activator (tPA, Activase) utilization in lieu of the recommended purge solution due to concern for thrombus formation of the purge pathway in a 51-year-old male with cardiogenic shock status-post Impella 5.5 heart pump placement for hemodynamic support while awaiting heart transplantation. The purge solution was successfully administered for 48 hours without complication and a reduction in average purge pressure with increase in purge flow rate was observed.