The use of a sentinel cerebral protection system during Impella CP removal in a patient with left ventricular thrombus.

Document Type

Article

Publication Date

8-1-2020

Publication Title

Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions

Abstract

Percutaneous mechanical circulatory support (pMCS) devices are commonly being utilized for hemodynamic support in patients undergoing high-risk percutaneous coronary interventions or stabilization for those in cardiogenic shock. Left ventricular (LV) to ascending aorta (Ao) rotodynamic pumps such as the Impella devices allow for rapid hemodynamic stabilization or support in such instances. The use of such devices is contraindicated in patients with known LV thrombus. However, it remains unclear on how to manage patients who develop an LV thrombus while on prolonged Impella support. While there are currently no cerebral embolic protection devices (CEPDs) approved for use in conjunction with LV to Ao pMCS devices or other short-term mechanical support devices, there is a theoretical benefit for the use of such technology in the right circumstances. We present a case describing the use of the sentinel cerebral protection system (SCPS) in a patient who developed LV thrombus while on Impella CP support. The use of the SCPS in this patient suggests a potential role for CEPD in prevention of thromboembolism while on Impella support.

Volume

96

Issue

2

First Page

504

Last Page

506

DOI

10.1002/ccd.28956

ISSN

1522-726X

PubMed ID

32384581

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