Epicardial Echocardiography for Correct Placement of the Intracardial Biventricular Assist Device (Impella®)

J. Ender; N. Anwar; S. Brose; M. Engel; A. Retry; R. Autschbach

doi:10.1055/s-2002-26692

The Thoracic and Cardiovascular Surgeon, Table of Contents

Thorac Cardiovasc Surg 2002; 50(2): 92-94
DOI: 10.1055/s-2002-26692

Original Cardiovascular

Original Paper
© Georg Thieme Verlag Stuttgart · New York

Epicardial Echocardiography for Correct Placement of the Intracardial Biventricular Assist Device (Impella®)[*]

J. Ender¹ , N. Anwar¹ , S. Brose² , M. Engel² , A. Retry¹ , R. Autschbach²

¹Abteilung für Anästhesiologie und Intensivmedizin II, Author's current institution: Klinik für Anästhesiologie und Intensivmedizin, Parkkrankenhaus, Leipzig, Germany
²Klinik für Herzchirurgie, Universität Leipzig, Herzzentrum, Leipzig, Germany

Presented at the 30th Annual meeting of the German Society for Thoracic and Cardiovascular Surgery in Leipzig, February 18 - 21, 2001

Abstract

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Abstract

Background: Correct placement of the intracardial biventricular assist device (Impella®) as a supporting system for off-pump coronary surgery is routinely checked by transesophageal echocardiography and invasive pressure measurements. However, it remains difficult to verify the accurate position of the right heart system when the posterior wall is exposed. Methods: In 23 patients undergoing augmented beating heart CABG surgery, the correct placement of the lmpella®-system was controlled by TEE as well as by a new 15-6 L epicardial echotransducer (EE) (Agilent, Andover, MA). Results: TEE assisted well in inserting the system in all patients. The correct placement of the distal end of the right heart system 1.5 cm behind the pulmonary valve was verified in 18/23 cases by TEE vs. 23/23 cases by EE. Dislocation of the devices during tilting of the heart could only be verified by EE. Conclusions: Epicardial echocardiography is a useful, innovative method for monitoring the correct placement of the new intracardial biventricular assist device during beating-heart surgery.

Key words

Epicardial echocardiography - Intracardiac assist device - Beating-heart surgery

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References

1 Meyns B, Siess P, Zietkiewicz M, et al. Coronary artery bypass graft with biventricular microaxial pumps. Perfusion. 1999; 14 287-290
2 Meyns B, Sergeant P, Nishida T, et al. Micropumps to support the heart during CABG. Eur J Cardio-thorac Surg. 2000; 17 169-174
3 Shanewise J S, Cheung A T, Aronson S, et al. ASE/SCA Guidelines for performing a comprehensive intraoperative multiplane transesophageal echocardiography examination: recommendations of the American society of echocardiography council for intraoperative echocardiography and the society of cardiovascular anesthesiologists task force for certification in perioperative transesophageal echocardiography. Anesth Analg. 1999; 89 870-884

1 Presented at the 30th Annual meeting of the German Society for Thoracic and Cardiovascular Surgery in Leipzig, February 18 - 21, 2001

Dr. Jörg Ender

Klinik für Anästhesiologie und Intensivmedizin, Parkkrankenhaus Leipzig-Südost GmbH

Strümpellstraße 41

04289 Leipzig

Phone: + 49-341-864-0

Email: ender.cakai@parkkrankenhaus-leipzig.de