Implanting Impella 5.5 under Local Anesthesia.

IF 1.3 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Thoracic and Cardiovascular Surgeon Pub Date : 2024-06-01 Epub Date: 2023-07-18 DOI:10.1055/a-2132-4694

Kaveh Eghbalzadeh, Thorsten C W Wahlers, Antje Christin Deppe

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Abstract

Background: Surgically implanted Impella 5.5. delivers full cardiac support and left ventricular unloading for patients with heart failure. So far, the Impella device is implanted under general anesthesia (GA).

Material and methods: A total of n = 3 critically ill patients presented with acute heart failure in need of cardiac support. All patients suffered cardiogenic shock of varying etiology. Due to hemodynamically unstable conditions, GA was avoided. All implantations were performed solely under local anesthesia (LAS) without any regional anesthesia.

Results: All implantations were performed successfully under LAS with 60 mL of mepivacaine of 2% solution and ropivacaine of 1% solution (50:50 ratio). All devices were placed from the right axillary artery. One patient needed hematoma evacuation several days after surgery. No other Impella-related complication was observed.

Conclusion: A surgical implantation of the Impella 5.5 device under LAS is feasible and safe. Despite the small number of cases, no disadvantage can be described at the present moment. Our series should encourage physicians to perform the procedure under LAS.

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在局部麻醉下植入 Impella 5.5。

背景：手术植入的 Impella 5.5 为心力衰竭患者提供全面的心脏支持和左心室负荷。到目前为止，Impella 装置是在全身麻醉（GA）下植入的：共有 n = 3 名危重病人因急性心力衰竭需要心脏支持。所有患者都患有不同病因的心源性休克。由于血流动力学状况不稳定，因此避免了全身麻醉。所有植入手术均在局部麻醉（LAS）下进行，未进行任何区域麻醉：结果：所有植入手术均在局部麻醉（LAS）下成功进行，并使用了60毫升2%的甲哌卡因溶液和1%的罗哌卡因溶液（比例为50:50）。所有装置均从右腋动脉植入。一名患者在术后数天需要清除血肿。没有观察到其他与Impella相关的并发症：结论：在 LAS 下手术植入 Impella 5.5 装置是可行和安全的。结论：在 LAS 下手术植入 Impella 5.5 装置是可行和安全的，尽管病例数量较少，但目前还无法说明其缺点。我们的系列研究应鼓励医生在 LAS 下进行手术。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Thoracic and Cardiovascular Surgeon 医学-呼吸系统

CiteScore

3.40

自引率

6.70%

发文量

365

审稿时长

3 months

期刊介绍： The Thoracic and Cardiovascular Surgeon publishes articles of the highest standard from internationally recognized thoracic and cardiovascular surgeons, cardiologists, anesthesiologists, physiologists, and pathologists. This journal is an essential resource for anyone working in this field. Original articles, short communications, reviews and important meeting announcements keep you abreast of key clinical advances, as well as providing the theoretical background of cardiovascular and thoracic surgery. Case reports are published in our Open Access companion journal The Thoracic and Cardiovascular Surgeon Reports.