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

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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.

 

More info in the following video: 

 


 

Shockwave Coronary IVL catheter

Fig: Shockwave Coronary IVL catheter. 


Impella optical pressure sensor

 

Placement signal not reliable alarm

 

Image

 

 

 

 Tags: impella,shockwave,alert,security,damage,intravascular lithotripsy,plaque modification,calcification,percutaneous coronary intervention,risk,optical sensor,impella cp,impella 5.5,Shockwave Coronary IVL Catheter,Placement Signal Not Reliable,alarm,distance,support,flow,monitoring,position

 

 

 

 

 

IMPELLA DEVICE: PHYSICS AND PHYSIOLOGY (+)

 

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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

IMPELLA IMPELLER SCHEME
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. 


 

impella fiberoptic pressure sensor

  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 (+)

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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?