Cicudevices

IABP GUIDE 003: IABP PHYSIOLOGY, HEMODYNAMIC EFFECTS.

The intra-aortic balloon pump operates by inflating during diastole, displacing blood from the descending aorta, and then deflating just before systole, creating a temporary void in the aorta.

This mechanism generates its hemodynamic effects, which primarily aim to enhance coronary blood flow, improve systemic perfusion, reduce afterload and left ventricular end-diastolic pressure, and consequently lower cardiac workload, and augments the stroke volume.

This 3d model illustrates the functional mechanism of the intra-aortic balloon pump, which operates through a precise timing of inflation and deflation.

For more information about iabp operation, we invite you to watch our video on iabp physics. The link can be found in the description.

We will now explain in detail each of the hemodynamic effects of the intra-aortic balloon pump

Diastolic augmentation.

When the heart relaxes initiating the diastole, the balloon inflates, causing diastolic augmentation that leads to the following effects:

Increased coronary perfusion:

The inflation pushes blood back towards the heart, increasing blood flow to the coronary arteries.

Coronary perfusion occurs mainly during diastole, as myocardial relaxation allows unimpeded blood flow through the coronary vasculature, improving perfusion; in this part of the cardiac cycle is when the iabp inflates; this way inflation causes a rise in the aortic pressure that causes an increase in the coronary pressure gradient and therefore increases coronary flow.

This effect has already been demonstrated in well-established studies of cardiac physiology…

Learn more in this video:

Tags: IABP, diastolic augmentation, coronary perfusion, afterload, pv loop, intra-aortic balloon pump, cardiac support device, mechanical circulatory support, counterpulsation, hemodynamic support, cardiovascular physiology, medical animation, cardiac assist devices.

IMPELLA 5.5 2nd GENERATION (+)

In October 2022, the FDA approved the modifications made to the second-generation Impella 5.5 device, which began commercialization in 2023.

These modifications resulted in an improvement in the purge system and an enhancement of the repositioning system.

The updates to the purge system include several key improvements designed to enhance functionality and patient safety, such as a reduced external tubing, a modular purge line, and a new purge unit.

In the first-generation devices, the purge system featured a long tubing purge system measuring around 3 meters in length, which had to be secured with a clip system.

This caused issues due to the possibility of it getting caught on objects or trapped, for example, under the wheels of the hospital bed or the console cart.

Instead, second-generation devices incorporate a modular purge system.

Learn more in this video:

Tag: FDA, Purge system, reposition system, impella CP, impella RP, impella 5.5, first generation, second generation, purge filter, pressure reservoir, purge valve, purge tubing, white cable, sterile sleeve, anchoring ring, Touhy-Borst valve.

IMPELLA CP COMPONENTS: PUMP, MOTOR, SHAFT (+)

Impella CP pump.

The impella CP pump consists of an impeller that functions as an axial pump.

This impeller is enclosed within the pump housing.

The Impella pump consists of a central conical hub, into which two blades are inserted, designed in a helical shape around the hub.

These are the measurements of the impeller: 10 milimeters in length and 3 milimeters in diameter…

FIBEROPTIC PRESSURE SENSORS FOR MEDICAL USE (FABRY PEROT SENSOR) (+)

Fiber optic sensors have become increasingly important in medical applications due to their unique properties and advantages.

These sensors employ optical fibers to detect and measure various physiological parameters, offering significant benefits over traditional electronic sensors.At first, the only available method for continuously monitoring pressure in the circulatory system was the fluid-filled catheter method.

This method has several disadvantages, such as poor dynamic response causing damping or overshooting, movement artifacts, or the potential for obstruction.The key advantages of the fiberoptic sensors are as follows.

Small size and flexibility, Fiber optic sensors are thin, lightweight, and flexible, allowing for minimally invasive procedures and integration into small medical devices.

Electromagnetic interference immunity, they are immune to electromagnetic interference, making them safe for use during MRI, Radiofrequency procedures or electrocautery.

Biocompatibility, as Optical fibers can be sterilized using standard medical techniques and are chemically inert and nontoxic.

And, finally, Good dynamic response, minimizing the dumping or overshooting effects.Currently, this technology is used in multiple cardiovascular devices, for example in the Intraaortic balloon pump; in the transaortic microaxial pumps like Impella or Supira device; in the fractional flow reserve measurement; or in the IKOR device, a coronary microcatheter to measure coronary pressure and flow.

Learn more in this video:

Tag: fiberoptic, pressure, sensor, medical use, Fabry-Perot, interferometer, fluid-filled catheter, advantages, IABP, Impella, Supira, FFR, IKOR, light beam, membrane, diaphragm, photodetector, light source, coupler

IABP PHYSICS, HOW IT WORKS (+)

IABP PHYSICS: SCROLL COMPRESSOR, SOLENOID VALVE, SAFETY DISC, FIBEROPTIC SENSOR.

The intra-aortic balloon pump (IABP) operates by inflating and deflating a balloon synchronized with the cardiac cycle.
The balloon is connected to a catheter, which is linked to a compressor generating positive and negative pressure.
Helium is the preferred gas due to its low viscosity, facilitating rapid inflation and deflation.
Early IABP models used a piston compressor, but modern versions employ a scroll compressor, offering advantages such as improved efficiency, reduced noise, lower mechanical failure rates, and a more compact size.
The scroll compressor functions by creating two pressure zones—negative at the inlet and positive at the outlet—by moving an orbiting scroll within a fixed scroll.
The system transmits pressure through tubes to a plunger, which displaces helium, inflating and deflating the balloon.

Learn more in the following video:

IMPELLA RP AND RP FLEX FDA ALERT (+)

14 Feb 2025, FDA issued a recall about risk of guidewire tip, indwelling central venus line or other medical devices coming into contact with the Impella RP, potentially causing a damage.

Abiomed highlights potential risk of interaction between guidewire tips, central venous lines, or other devices and the inlet of the Impella pumps RP or RP flex during insertion, adjustment, or removal...

Full video:

Tags: impella RP, impella RP flex, FDA, Alert, guidewire, central venous line, fiberoptic sensor, Placement Signal Not Reliable, alarm, Pump stoppage, Impella Stopped, restart.

SUPIRA DEVICE (*)

The Supira System is an advanced percutaneous ventricular assist device (pVAD) developed to provide temporary mechanical circulatory support during high-risk percutaneous coronary interventions (HRPCI) and cardiogenic shock (CS) cases. Featuring a low-profile, high-flow catheter pump, it aims to minimize vascular complications while delivering full hemodynamic support.
Key features include:
10F insertion profile, expanding to 22F upon deployment
Dual sensor system for real-time aortic and ventricular pressure monitoring
Designed for ≤ 4-hour temporary use in severe coronary artery disease patients

Learn more:

Tag: SUPIRA, SYSTEM, percutaneous ventricular assist device, Supira Medical, temporary mechanical circulatory support, high-risk percutaneous coronary interventions, cardiogenic shock,low-profile,high-flow, dual sensor, accurate monitoring, MOTOR, catheter, shaft, purge, console, driving, control.

IABP PHYSICS

IABP PHYSICS: SCROLL COMPRESSOR, SOLENOID VALVE, SAFETY DISC, FIBEROPTIC SENSOR.

Learn more in the following video:

Tags: IABP, physics, physiology, balloon, catheter, compressor, synchronization, helium, plunger, disc, scroll compressor, solenoid valve, trigger, fiberoptic, pressure, sensor, fabry-perot, interferometer, reflection, membrane, diaphragm, light,beam, console, photodetector.

IMPELLA COMPONENTS PART 2 (+)

Impella cp outlet area.

The outlet area is also referred to as the “pump housing” because this area contains the impeller.

It is located in the proximal portion of the cannula.

It consists of a cylindrical cage structure, designed with six windows and six metal struts.

This outlet cage is the region through wich blood is ejected into the aorta.

The measurements of the outlet area are as follows:

It area has a length of 3 mm

A diameter of 4.6 mm, which is equivalent to 14 french.

It features 6 windows for the ejected blood to exit, each with a width of 1.8 mm.

All of this results in an outlet area of approximately 0.5 cm².

… FULL VIDEO IN OUR YOUTUBE CHANNEL:

TAGS: impella, outlet, pump housing, ejection, chamfered, shear stress, hemolysis, easyguide lumen, guidewire, monorail, fiberoptic, laser, pressure sensor, Fabry-Perot, miniaturization, EMI, struts, capsule, bump, visor

MAGENTA ELEVATE (*)

The Magenta Elevate device, developed by the company Magenta Medical is a catheter-mounted, self-expandable, and retrievable microaxial flow pump designed to actively transport blood from the left ventricle to the ascending aorta.

It is intended for temporary mechanical circulatory support of the left ventricle during high-risk percutaneous coronary interventions and in patients hospitalized with cardiogenic shock.

It can deliver over 5 Liters per minute of mean flow from the left ventricle to the ascending aorta.

The impeller features a helical design that allows for its radial constraining for crimping and vascular insertion.

Once positioned within the left ventricle, the impeller self-expands to its working shape.

-> Full video:

Tags: magenta medical, magenta elevate, axial, microaxial, pump, heart, device, catheter, mounted, crimped, expandable, retrievable, HRPCI, shock, helical, motor, external, sheath.

IMPELLA COMPONENTS PART 1 (*)

IMPELLA TUTORIAL 008: IMPELLA CP COMPONENTS PART 1

The Impella CP is a mechanical circulatory support device designed to provide percutaneous left ventricular assistance during percutaneous coronary interventions or cardiogenic shock.

Understanding the structure and functionality of the device's individual components is essential for optimizing its use, ensuring accurate placement, and minimizing potential complications.

A detailed overview of the various components of the Impella CP is provided, emphasizing their design, function, and contribution to achieving effective ventricular unloading and circulatory support.

In a structured manner, the components of the Impella CP can be divided into four categories: the Impella catheter, the purge system, the insertion kit, and the automatic impella controller.

Watch the full video:

Tags: impella, impella cp, components, parts, pigtail, teardrop, inlet, cannula, guidewire, easyguide, screw, cage, suction, Polyurethane, tube, nitinol, coil, reinforced, marker.

ECMO HISTORY (+)

ECMO HISTORY, A FASCINATING JOURNEY THROUGH THE EVOLUTION OF EXTRACORPOREAL LIFE SUPPORT. #ECMO

We can trace the origins of ECMO support to the early days of cardiopulmonary bypass.
In 1953, John Gibbon successfully performed the first operation under cardiopulmonary bypass.

He repaired an atrial septal defect in an 18-year-old woman at the Jefferson Medical College of Philadelphia.

The patient underwent a successful intervention during 26 minutes of total cardiopulmonary bypass and survived hospital discharge without significant adverse events.
This achievement was the result of two decades of prior research in circulatory support devices and artificial lungs.

It essentially consisted of a roller pump and a gas exchange area that involved small films of deoxygenated blood passing over a screen where it made direct contact with oxygen.

This system allowed circulatory support for a few hours to perform cardiac surgeries, but it was not useful for prolonged support in the ICU because direct exposure to oxygen caused damage to blood cells.In 1972, a 24-year-old man with severe acute respiratory distress syndrome caused by polytrauma became the first patient to successfully undergo prolonged extracorporeal life support for 75 hours at the Pacific Medical Center, ultimately recovering.

This event marked the advent of what we now call ECMO.

In the years that followed, attempts were made to validate its effectiveness in treating adult respiratory distress, but these efforts showed no significant impact on mortality.In contrast in 1972, doctors Bartlett and Gazzaniga successfully treated their first patient with ECMO after cardiac surgery, a 2-year-old infant who developed myocardial stunning following a Mustard procedure.

This represented the first use of cardiac ECMO, successfully providing 36 hours of support until recovery.

The team later documented a growing number of pediatric cardiac cases using this techniqueIn 1975, once again, doctors Bartlett and Gazzaniga achieved a new milestone.

That year, they successfully treated the first newborn using ECMO in a case of persistent ductus arteriosus with cyanosis.

They managed to sustain the baby’s circulation and oxygenation until the defect could be repaired, marking a pivotal moment in medical history.

This case proved to be crucial, because it initiated the study and development of extracorporeal support in newborns over the following 20 years.

Based on the neonatal experience, ECMO was subsequently reintroduced years later for adult respiratory and cardiac failure, paving the way for its widespread use across all age groups to treat both cardiac and respiratory failure, which is the current standard of care.

Watch the full content in the following video: https://youtu.be/I53g5-rDpO8?si=wGG9mAZFkvwZZn0h

Tags: ecmo, history, support, cardiopulmonary bypass, gibbon, operation, intervention, circulatory support, roller pump, screen, surgery, Bartlett, Gazzaniga, Mustard, newborn, cyanosis, pump, coagulation, centrifugal pump, magnetically levitated pump, shear stress, hemolysis, lung, carbon dioxide, Bubble oxygenator, deWall, dimethylpolysiloxane, silicone, membrane, Kolobow, Microporous, Polypropylene, Hollow-Fiber ,Oxygenator, Intra-capillary, Extra-capillary, polymethylpentene, nanopores, Maquet, Quadrox, Cardiohelp.

IMPELLA INTERACTION WITH FIBERS OF STERILE GAUZES (+)

Impella devices are typically implanted in the hemodynamics laboratory or the operating room, where sterile gauzes made of interwoven fibers are commonly used.

These sterile gauzes are absorbent pads made of cotton or synthetic materials.

Typically, the gauzes used in the cath lab or operating room are X-ray detectable, as they contain a radiopaque thread or strip to make them visible on X-rays, helping prevent retention of gauze inside the patient.

Often, surgical gauzes are designed to be lint-free to avoid leaving these fibers in the surgical site.

But there is always the possibility that a fiber may come loose and end up in the surgical field or in the sterile saline containers.

Abiomed identified that in the analysis of some cases of low flow or pump thrombosis the clot may form around a matrix of white or blue fibers.

IMPELLA RISK OF VENTRICLE PERFORATION (+)

The Impella CP and 5.5 devices are cardiac assist systems used for hemodynamic support in cases of high risk PCI or cardiogenic shock.

They are advanced over a guidewire and placed inside the left ventricle.

One of the reported complications is left ventricular perforation due to catheter manipulation during insertion or repositioning.

In February 2024, The FDA issued a recall regarding Impella left sided blood pumps due to perforation risks.

The company Abiomed, due to reported cases, announced an update to the instructions for use of the Impella CP and Impella 5 point 5 devices to include the possibility of cardiac perforation and the measures to take to prevent it.

Complete and detailed information in the next video:

Fig: Impella CP positioning.

Fig: Impella Tuohy Borst Valve

Fig: Repositioning unit.

Fig: Impella 5.5 position.

Fig: Impella 5.5 repositioning unit.

Tags: impella, iatrogenic, perforation, risk, high risk PCI, HRPCI, shock, cardiogenic shock, complication, FDA, FDA recall, IFU, pacing electrode, pulmonary artery catheter, TAVR, TAVI, ablation catheter, Amplazter closure device, position, Tuohy-Borst valve, sheath, repositioning unit, echocardiogram, impella cp, impella 5.5, fixation, CPR, aneurism.

IMPELLA ECP, DESCRIPTION AND OPERATION, AFTER TCT 2024 PIVOTAL TRIAL PRESENTATION. (+)

n 2024, at the TCT congress, the Impella ECP pivotal trial results were presented.

At that time, the only Impella catheter approved for High Risk PCI was the Impella CP, a device with a maximum diameter of 14 French.

The Impella ECP was designed to provide hemodynamic support during high-risk PCI, allowing for a reduction in arterial sheath access size to 9 French, as It incorporates a compressible 21 French pump.

Complete information in the next video:

FIGURE: IMPELLA ECP CATHETER.

FIGURE: IMPELLA ECP PIGTAIL, INFLOW, OUTFLOW.

FIGURE: IMPELLA ECP SCREEN.

FIGURE: IMPELLA ECP: PIGTAIL, INFLOW.

TAGS: impella, impella ECP, impella CP, high risk PCI, HRPCI, 6h, Expandable cardiac output, expandable, compresible, 21F, 9F, sheath, retrieve, pigtail, impeller, inflow, outflow, cannula, shaft, motor, red handle, hemopump, history, wireless, delivery, insertion, mean flow, average flow, expected flow, screen, optical sensor, removal, resheath, re-sheath, angioseal, angioseal 8F, FDA, submitted, aproval.

IMPELLA AND TAVR/TAVI INTERACTION, ALSO FOR SUTURELESS OR CALCIFIED AORTIC VALVES. (+)

IMPELLA AND TAVR/TAVI INTERACTION, ALSO FOR SUTURELESS OR CALCIFIED AORTIC VALVES.

Transcatheter Aortic Valve Replacement is a minimally invasive procedure used to treat aortic valve stenosis

As of 2024, more than 300,000 implants have been performed worldwide.

In a simple way, two types of TAVR can be distinguished: self-expanding and balloon-expandable.

The use of the Impella device has been continuously increasing in recent years as hemodynamic support in cardiogenic shock and high-risk PCI.

Therefore, there will be in the future an increasing number of cases where the implantation of Impella in patients with prior TAVR may be considered.

It has been previously reported that interaction can occur between Impella and those self-expanding TAVR with a wide strut area in the supra-annular region

So caution must be taken when using Impella in the presence of this kind of TAVR.

IMPELLA AND SHOCK WAVE, SECURITY ALERT, RISK OF OPTICAL SENSOR DAMAGE (+)

Impella security alert, risk of optical sensor damage when shockwave is used.

In the recent years, intravascular lithotripsy has emerged as a new technique for coronary calcified plaque modification.

It generates circumferential sonic pressure waves to fracture both surface and deep calcifications in the vessel wall, while limiting injury to the soft tissues.

In september 2024 Abiomed issued a security alert regarding the Impella support when coronary Shockwave is used for percutaneous coronary intervention.

The company has identified a risk of optical sensor damage when used concurrently in close proximity with Shockwave Coronary IVL Catheter.

This alert affects the Impella CP and Impella 5.5 devices.

IMPELLA DEVICE: PHYSICS AND PHYSIOLOGY (+)

IMPELLA DEVICE TUTORIAL GUIDE 001: IMPELLA DEVICE PHYSICS AND PHYSIOLOGY, IMPELLER AND OPTICAL PRESSURE SENSOR

• Impella tutorial 001. Physics.

• Impella tutorial 002. LVEDP and CO monitoring.

• Impella tutorial 003: Physiology.

• Impella tutorial 004: Smartassist.

• Impella tutorial 005: History.

• Impella tutorial 006: Family.

• Impella tutorial 007: Indications.

Impella physics and physiology. How does Impella operates? What is Impella?

Impella device is a heart pump.

This is a summary; more information is available in our YouTube video.

1. This device is at its core, it's nothing more than a propeller.

Its design creates suction at one end and ejection at the other.

2. Impella device is a microaxial pump. So, the flow it generates follows the principles of such machines

3. Impella catheter is an axial pump and the primary factor determining flow and current in the same patient is pressure difference.

4. The axial pump mechanism of the Impella is not completely isolated from the bloodstream. This would result in some blood flow entering the system

5. Pressure measurement.

The device can determine pressure in real time using optical fiber and laser.

6. The system can estimate the left ventricular pressure and display a real-time curve, as well as estimate the left ventricular end-diastolic pressure.

7. The Impella software can infer, based on an initial measurement, the evolution over the following hours of total cardiac output, native output, and cardiac power output.

Tags: Impella, device, tutorial, guide, inlet, outlet, current, flow, impeller, pressure gradient, purge system, fiberoptic, optical pressure sensor, laser, beam, smartassist, management, basics

Fig 1: Impella device impeller

Fig 2. Impella physics, low pressure difference, high flow and high current consumed.

Fig 3. Impella physics, high pressure difference, low flow and low current consumed.

Fig 4. Impella fiberoptic, optical pressure sensor scheme .

Tags: Impella, Tutorial, Guide, Inlet, Outlet, Current, Flow, Impeller, Pressure gradient, Purge system, Optical pressure sensor, Laser, Smartassist, Impella management, design, how does impella work, what is the power of impella pump, how does impella operates? How does impella work? What is impella?

SYSTOLIC AORTIC REGURGITATION (+)

CICU CHALLENGE 002: SYSTOLIC AORTIC REGURGITATION DURING VENOARTERIAL ECMO SUPPORT.

Male 55yo, familial DCM, with ICD. Admitted to ER with arrhytmic storm and shock. #ECMO iniciated. 3h later, arterial line without pulsatility. TOE performed.

¿How can this systolic AR be explained?

ABIOMED REMOVES CERTAIN IMPELLA CP DUE TO FAILED QUALITY INSPECTIONS. FDA RECALL, AUGUST 2024.

Abiomed sent customers voluntary recall of removal in May 2024.

9 Impella CP of a single lot failed inspection but were mistakenly distributed.

Expanded and detailed information in this video:

Source FDA:

https://www.fda.gov/medical-devices/medical-device-recalls/heart-pump-recall-abiomed-removes-certain-impella-cp-smartassist-systems-due-failed-quality

HEARTMATE LVAD EOGO: EXTRINSIC OUTFLOW GRAFT OBSTRUCTION (+)

Abbott Heartmate EOGO: Extrinsic Outflow Graft Obstruction.

Extrinsic outflow graft obstruction (EOGO) is triggered by accumulation of acellular biodebris between outflow graft and bend relief.

This accumulation occurs gradually over an extended period of support (> 2 years).

Extended and detailed information in this video:

Tags: LVAD, Heartmate 2 and 3, EOGO, biodebris, acellular, outflow graft, bend, relief, gore tex, incidence, gelatinous, matrix, fabric, layers, hematoxylin, eosin, animation, low flow, alarm, hemodynamic compromise, death, shock, heart failure, CT angiogram, angiography, IVUS, stent, surgical decompression, pump replacement, heart transplantarion.

IMPELLA DEVICE TUTORIAL GUIDE 007: IMPELLA CP INDICATIONS, CONTRAINDICATIONS AND OF-LABEL USE (+)

• Impella tutorial 001. Physics.

• Impella tutorial 002. LVEDP and CO monitoring.

• Impella tutorial 003: Physiology.

• Impella tutorial 004: Smartassist.

• Impella tutorial 005: History.

• Impella tutorial 006: Family.

• Impella tutorial 007: Indications.

We could distinguish between the approved or on-label indications of Impella and the indications considered in real-world use.

Expanded and detailed information in this video:

Tags: impella cp, indication, contraindication, off-label use, FDA, high risk pci, percutaneous coronary intervention, left main, cto, cronic total occlusions, multivessel, bifurcation, inestability, cardiogenic shock, AMI, acute myocardial infarction, surgery, myocarditis, ecmella, ecpella, arrhythmia, ablation, support, ventricular septal rupture, transcava, why would a patient need an impella?

IMPELLA DEVICE TUTORIAL GUIDE 006: IMPELLA FAMILY (+)

• Impella tutorial 001. Physics.

• Impella tutorial 002. LVEDP and CO monitoring.

• Impella tutorial 003: Physiology.

• Impella tutorial 004: Smartassist.

• Impella tutorial 005: History.

• Impella tutorial 006: Family.

• Impella tutorial 007: Indications.

Nowadays, we can say that the Impella catheters available for use in clinical practice are:

🔹LV support:

- Impella CP

- Impella 5.5

🔹RV support:

- Impella RP

- Impella RP Flex

Expanded and detailed information in this video:

Tags: impella, impella cp, impella 5.5, inpella rp, impella rp flex, impella eco, impella btr, size, flow, indication, insertion, femoral artery, aorta, axillar artery, expandable, cardiac power, bridge to recovery,

IMPELLA DEVICE TUTORIAL GUIDE 004: SMARTASSIST SYSTEM (+)

• Impella tutorial 001. Physics.

• Impella tutorial 002. LVEDP and CO monitoring.

• Impella tutorial 003: Physiology.

• Impella tutorial 004: Smartassist.

• Impella tutorial 005: History.

• Impella tutorial 006: Family.

• Impella tutorial 007: Indications.

SmartAssist is a monitoring system integrated into the next-gen catheters and Impella console. It enables greater support, allows more precise positioning of the catheter, improved detection of suction events and better weaning guidance.

Expanded and detailed information in this video:

Tags: impella, smartassist, catheter, optical pressure sensor, laser, fiberoptic, position control, LVEDP, parameter accuracy, suction events, weaning management, formula, cardiac output, CO, cardiac power output, impella flow

IMPELLA TUTORIAL 003: PHYSIOLOGY (+)

• Impella tutorial 001. Physics.

• Impella tutorial 002. LVEDP and CO monitoring.

• Impella tutorial 003: Physiology.

• Impella tutorial 004: Smartassist.

• Impella tutorial 005: History.

• Impella tutorial 006: Family.

• Impella tutorial 007: Indications.

IMPELLA PHYSIOLOGY.

1. Impella suctions blood from inlet and ejects it towards the outlet. Since the device consistently empties the ventricle during both systole and diastole, it diminishes both afterload and preload.

Expanded and detailed information about this topic in the following video:

Tags: impella, tutorial, guide, left ventricle pressure, smartassist, physiology, pv loop, uncoupling, impella management, cardiac output, coronary flow, wall stress.

IMPELLA PHYSICS AND PHYSIOLOGY, CARDIAC OUTPUT MONITORING (+)

IMPELLA DEVICE TUTORIAL GUIDE 002, PHYSICS AND PHYSIOLOGY, CARDIAC OUTPUT MONITORING

The system can estimate the left ventricular pressure and display a real-time curve, as well as estimate the left ventricular end-diastolic pressure.

• Impella tutorial 001. Physics.

• Impella tutorial 002. LVEDP and CO monitoring.

• Impella tutorial 003: Physiology.

• Impella tutorial 004: Smartassist.

• Impella tutorial 005: History.

• Impella tutorial 006: Family.

• Impella tutorial 007: Indications.

Expanded and detailed information in this video:

Fig: Left ventricle pressure measured by impella

LVAD AND ECG ARTIFACT, HOW TO PERFORM A PROPER ECG IN LVAD PATIENT. (+)

Electrical artifacts in ECG are frequent after LVAD implantation, and they can complicate ECG interpretation

This is a summary, expanded and detailed content in this video:

It is hypothesized that centrifugal pump high-frequency oscillations cause noise artifacts on ECGs in patients using LVADs.

The L-vads currently operating in clinical practice are the Heartware, the heartmate 2, and the Heartmate 3. Each L-vad model has its own operating revolutions per minute level, generating different frequency interferences

So How to perform an ECG with minimal artifacts in a patient with an LVAD?

Tags: ecg, lvad, oscillation, artifact, high frequency, heartware, heartmate, heartmate 2, heartmate 3, hertz, artificial pulse, signal, p wave, qrs, t wave, filter, low pass filter, pacemaker, spike,amplitude

EMERGENCY DRIVE IMPAIRED OR INABILITY TO TURN THE DRIVE. FDA RECALL, AUGUST 2023.

In August 2023, FDA recall was published, due to a defect in emergency drive of the Cardiohelp console.

In some units. emergency drive may get stuck.

In situations where the emergency drive is required, a clinician may encounter difficulty turning the handle to operate the pump or may not be able to turn it at the required speed to adequately support the patient. If such challenges arise, the patient may experience a loss of sufficient hemodynamic support or gas exchange, leading to potential consequences like ischemia, hypoxia, stroke, or even death.

The measures to be taken are: Promptly inspect your existing inventory to identify any CARDIOHELP Emergency Drives that may be affected, notify Getinge immediately and ensure that an alternative emergency support method is readily available at all times.

INDEX OF BLOG POSTS, ECMO, IMPELLA, IABP, LVAD, FLOWTRIEVER

IABP (Intraaortic balloon pump)

• Maquet/Getinge Recalls Cardiosave Hybrid and Rescue Intra-aortic Balloon Pumps (IABPs) for Unexpected Shutdowns [Link]

• Datascope/Maquet/Getinge Recalls Cardiosave Hybrid and Rescue Intra-aortic Balloon Pumps (IABPs) for PCBA Failures Affecting the Ability to Charge the Batteries Leading to Unexpected Shutdowns [Link]

IMPELLA:

• Impella device physics and physiology [Link]

ECMO (extracorporeal membrane oxygenation):

• Getinge/Maquet Cardiohelp FDA recall. Potential insufficient packaging sterility. [Link]

LVAD (left ventricle assist device):

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