Agostino La Marca

Arturo Giordano

Germano Coronella

Mario Monaco

Paolo Pepino

Raffaela Provenzano

Salvatore Giordano

Journal of Cardiothoracic Surgery

PubMed

Springer - Publisher Connector

MEETING ABSTRACT Open Access
Use of impella for off pump myocardial
revascularization in high risk patients
Paolo Pepino1*, Germano Coronella1, Salvatore Giordano1, Raffaela Provenzano1, Agostino La Marca2,
Mario Monaco2, Arturo Giordano3
From World Society of Cardiothoracic Surgeons 25th Anniversary Congress, Edinburgh
Edinburgh, UK. 19-22 September 2015
Background/Introduction
Patients undergoing coronary surgery are changed in the
last years becoming a challenge for the cardiac surgeon
not only for the quality of the coronary artery involved
in the disease but also for the quality of patients. Low
ejection fraction, elderly, COPD, kidney failure, Diabetes
are often found in patients with coronary artery disease
undergoing CABG.
Aims/Objectives
Beating heart myocardial revascularization is a well-
established surgical technique but in case of very low EF
(below 30%) there is a particular high surgical risk of
conversion to on-pump surgery. The recently developed
of Impella device (Abiomed, Danvers, MA) represent a
compromise between circulatory support and limited
invasiveness.
Method
Three patients, male, admitted for acute coronary syn-
drome with three vessels CAD and low ejection fraction
below 30 %, were operated in our department. After pre-
liminary lower limb duplex ultrasound to exclude periph-
eral artery disease, an Impella Recover LP 5.0 device was
inserted via surgical exposure of the right femoral artery
in one case and an Impella recover LP 4,5 via percuta-
neous insertion of the femoral artery in two cases.
Results
The myocardial revascularization was performed using a
complete arterial revascularization: Left internal mammary
artery on the LAD and the radial artery “T” anastomosed
from the LIMA to the other vessels (diagonal, intermedius
ramus, OM and PDA). The device was left in for 48 Hours
after the operation. All patients were discharged home
after 9-10 days after admission and a follow up echocar-
diography performed six month after the operation
showed an increase of the ejection fraction up to 40-45%.
Discussion/Conclusion
Use of the Impella Recover device for patients undergoing
off pump CABG is feasible and safe, and appears a promis-
ing strategy to improve short- and long-term outcomes.
Authors’ details
1Department of Cardiothoracic Surgery, Presidio Ospedaliero Pineta Grande,
Castel Volturno, Caserta, Italy. 2Department of Vascular Surgery, Presidio
Ospedaliero Pineta Grande, Castel Volturno, Caserta, Italy. 3Department of
Invasive Cardiology, Presidio Ospedaliero Pineta Grande, Castel Voturno,
Caserta, Italy.
Published: 16 December 2015
doi:10.1186/1749-8090-10-S1-A160
Cite this article as: Pepino et al.: Use of impella for off pump
myocardial revascularization in high risk patients. Journal of
Cardiothoracic Surgery 2015 10(Suppl 1):A160.
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1Department of Cardiothoracic Surgery, Presidio Ospedaliero Pineta Grande,
Castel Volturno, Caserta, Italy
Full list of author information is available at the end of the article
Pepino et al. Journal of Cardiothoracic Surgery 2015, 10(Suppl 1):A160
http://www.cardiothoracicsurgery.org/content/10/S1/A160
© 2015 Pepino et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://
creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the
original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/
zero/1.0/) applies to the data made available in this article, unless otherwise stated.


Use of impella for off pump myocardial revascularization in high risk patients

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http://dx.doi.org/10.1186/1749-8090-10-S1-A160

Use of impella for off pump myocardial revascularization in high risk patients

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