Impella 5.0 for Cardiogenic Shock After Thrombectomy in a Patient With Intraventricular Thrombosis

Can J Cardiol. 2020 Oct;36(10):1690.e13-1690.e15. doi: 10.1016/j.cjca.2020.04.005. Epub 2020 Apr 11.

Abstract

A 43-year-old man was admitted to a referring hospital for cardiogenic shock caused by dilated cardiomyopathy. Intra-aortic balloon pump and percutaneous venoarterial extracorporeal membrane oxygenation (VA-ECMO) were started initially; however, a thrombus was detected in the left ventricle. After transfer to our institution, we performed thrombectomy through minithoracotomy. Subsequently, an Impella 5.0 device was inserted via the left subclavian artery. His cardiac function gradually improved, and both VA-ECMO and the Impella 5.0 could be weaned off. He was discharged without any thromboembolic event. Impella insertion with thrombectomy was possible, minimally invasive, and effective for a patient with intraventricular thrombosis associated with VA-ECMO.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Cardiomyopathy, Dilated / complications*
  • Embolic Protection Devices
  • Extracorporeal Membrane Oxygenation / methods*
  • Heart Ventricles* / diagnostic imaging
  • Heart Ventricles* / pathology
  • Humans
  • Intra-Aortic Balloon Pumping / methods*
  • Male
  • Minimally Invasive Surgical Procedures / methods
  • Shock, Cardiogenic* / etiology
  • Shock, Cardiogenic* / physiopathology
  • Shock, Cardiogenic* / therapy
  • Subclavian Artery / surgery
  • Thoracotomy / methods
  • Thrombectomy / methods*
  • Thrombosis* / diagnostic imaging
  • Thrombosis* / etiology
  • Thrombosis* / surgery