Minimally Invasive Direct Aortic Implantation of Impella 5.5 As Bridge to Transplant: A Case Report

Abstract

The use of temporary mechanical circulatory support (t-MCS) in cardiogenic shock (CS) is increasing.The Impella (Abiomed) is a percutaneous, microaxial ventricular assist device approved for short-term use in CS that can be implanted peripherally. Direct aortic placement is an alternative commonly performed when the sternum is open, for example, in post-cardiotomy shock, or when the peripheral vasculature is of insufficient size or quality for implantation. Herein we describe direct aortic implantation of the Impella 5.5 via right mini-thoracotomy for a patient in CS secondary to decompensated heart failure as a bridge to candidacy, and ultimately, transplantation.