Open AccessDirect Pull-Through Technique to Insert the Impella RP Device Without Using Fluoroscopy
Author(s) -
Suguru Ohira,
David Spielvogel,
Steven Lansman,
Masashi Kai
Publication year - 2021
Publication title -
asaio journal
Language(s) - English
Resource type - Journals
eISSN - 1538-943X
pISSN - 1058-2916
DOI - 10.1097/mat.0000000000001446
Subject(s) - fluoroscopy , medicine , tricuspid valve , impella , superior vena cava , clamp , right atrium , femoral vein , surgery , cardiology , cardiogenic shock , mechanical engineering , clamping , engineering , myocardial infarction
We describe a technique for insertion of the Impella RP device that does not require fluoroscopy. Venous cannulation was performed via the superior vena cava and femoral vein percutaneously. After right atriotomy, the Impella RP is percutaneously inserted and advanced to the right atrium under transesophageal echocardiography guidance. Next, via a longitudinal 2 cm incision in the main pulmonary artery (PA), a large C-shaped clamp is advanced retrograde through the pulmonic and tricuspid valves into the right atrium. The pigtail portion is grasped, pulled through to the main PA, and the device is positioned in the PA under direct vision.