Int J Angiol 2019; 28(02): 118-123
DOI: 10.1055/s-0038-1676369
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The Impella Device: Historical Background, Clinical Applications and Future Directions

James J. Glazier
1   Department of Cardiology, Wayne State University/Detroit Medical Center, Heart Hospital, Detroit, Michigan
,
Amir Kaki
1   Department of Cardiology, Wayne State University/Detroit Medical Center, Heart Hospital, Detroit, Michigan
› Author Affiliations
Funding None.
Further Information

Publication History

Publication Date:
20 December 2018 (online)

Abstract

The Impella device is a catheter-based miniaturized ventricular assist device. Using a retrograde femoral artery access, it is placed in the left ventricle across the aortic valve. The device pumps blood from left ventricle into ascending aorta and helps to maintain a systemic circulation at an upper rate between 2.5 and 5.0 L/min. This results in almost immediate and sustained unloading of the left ventricle, while increasing overall systemic cardiac output. The most common indications for using the Impella device are in the treatment of acute myocardial infarction complicated by cardiogenic shock and to facilitate high risk coronary angioplasty. Other indications include the treatment of cardiomyopathy with acute decompensation, postcardiotomy shock, and off-pump coronary bypass surgery. A growing body of observational and registry data suggest a potentially valuable role for the Impella system in reducing the mortality associated with cardiogenic shock. However, there are, as of yet, no randomized controlled trial data supporting this observation.

Authorship

All authors had access to the data and a role in writing the manuscript.