Impella-5.5®: Modern cardiac support therapy at the University Medical Centre Magdeburg
At the University Clinic for Cardiac and Thoracic Surgery Magdeburg, under the direction of Prof Dr Jens Wippermann, a new type of minimally invasive heart pump was successfully used to save the life of a 50-year-old patient with severe heart failure. The so-called Impella-5.5® made it possible to provide effective circulatory support without the need for prolonged anaesthesia or ventilation - a significant advance in the treatment of critically ill heart patients.
The Impella-5.5® is a small heart pump. It continuously pumps blood from the left ventricle into the aorta and thus relieves the weakened heart. In contrast to the Impella CP®, which is inserted via the inguinal artery, the Impella-5.5® is surgically implanted - for example via the axillary artery (subclavian artery) or, as in this case, directly via the aorta. The pump can deliver up to 5.5 litres of blood per minute and allows the patient to move and be slowly weaned off the support.
The patient was admitted from a peripheral hospital in a life-threatening condition. He was diagnosed with ischaemic cardiomyopathy (ICM) with a severely reduced left ventricular ejection fraction (LVEF 10%) and severe coronary three-vessel disease.
During the urgently indicated triple bypass operation using the heart-lung machine (HLM), the Impella-5.5® was used to continue supporting the heart after the end of the HLM period, which is otherwise only possible using ECMO. For this purpose, the pump was implanted via a vascular prosthesis sutured to the ascending aorta (main artery) and discharged via the trigonum caroticum in the patient's neck so that the thorax could be closed.
Photo: (from left): Susanne Pilz, Head of Nursing at the Cardiac Surgical Intensive Care Unit; Stefan Watzek, Deputy Senior Cardiotechnician at the University Clinic for Cardiac and Thoracic Surgery; Olga Shostak, Functional Senior Physician, Head of the Cardiac Surgical Intensive Care Unit Magdeburg. Patient Joerg Hahne on the sixth postoperative day, accompanied by Dr George Awad, Senior Consultant at the University Clinic for Cardiac and Thoracic Surgery Magdeburg. Photographer: Melitta Schubert/UMMD
The patient was successfully weaned from mechanical ventilation on the second postoperative day. On the third day, the patient was mobilised to the edge of the bed. The heart pump was removed from the bed on the seventh day after it had previously been gradually reduced. Under optimised drug therapy, the patient continued to show stable progress and was discharged for rehabilitation on the 14th postoperative day.
The transaortic implantation of this modern ventricular assist device represents a promising alternative to classic central ECMO, particularly in patients with preserved right ventricular function and a stable respiratory situation.
The method offers a gentler therapy option with shorter ventilation times and improved patient comfort. It also creates valuable time for myocardial recovery or evaluation for further therapies such as LVAD implantation or heart transplantation.
By using the Impella-5.5®, Magdeburg University Hospital is taking an important step towards modern cardiac surgery and contemporary patient care.
Contact
Dr. med. George Awad
University Medical Centre Magdeburg
University Clinic for Cardiac and Thoracic Surgery
Head: Prof. Dr Jens Wippermann