Abstract
BackgroundThe IMPELLA® is a minimally invasive left ventricular assist device. We report a case in which transesophageal echocardiography (TEE) was useful in diagnosis of left ventricular rupture after IMPELLA® insertion.Case presentationA 75-year-old man presented to the emergency room with chest pain and underwent percutaneous coronary intervention for 100% stenosis of the left anterior descending branch #7. An IMPELLA® was inserted to stabilize the circulation, but hypotension persisted. Transthoracic echocardiography revealed increased pericardial effusion and suspicion of free wall left ventricular rupture, leading to emergency surgery. TEE revealed the IMPELLA® straying into the left ventricle apical wall and cardiac tamponade. Hemorrhage was observed from the thinning free wall and the tip of the IMPELLA® was palpable. The IMPELLA® was removed and the left ventricular wall was repaired.ConclusionsThe IMPELLA® requires implantation of the tip in the left ventricle, but it should be noted that a fragile ventricular wall can be easily perforated.
Highlights
The IMPELLA® is a minimally invasive left ventricular assist device
The IMPELLA® requires implantation of the tip in the left ventricle, but it should be noted that a fragile ventricular wall can be perforated
We report a case of left ventricular free wall rupture after insertion of an IMPELLA® that was diagnosed by transesophageal echocardiography (TEE)
Summary
The IMPELLA® requires implantation of the tip in the left ventricle, but it should be noted that a fragile ventricular wall can be perforated.
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