Abstract
Despite optimal medical management, some patients with severe right ventricular failure fail to respond and may benefit from additional support with the implantation of a RV assist device. Experience to date with Impella RP is limited. We report a case of percutaneous Impella RP implantation, using a parallel stiff wire to reduce anatomical tortuosity by acting as a buddy-wire to facilitate device implantation and reduce the risk of tricuspid ring damage in a patient recently treated with tricuspid ring annuloplasty.
Highlights
- •
Despite optimal medical management, some patients with severe right ventricular failure fail to respond and may benefit from additional support with the implantation of a RV assist device.
- •
Experience to date with Impella RP is limited and we report a case of percutaneous Impella RP implantation, using a parallel stiff wire to reduce anatomical tortuosity by acting as a buddy-wire to facilitate device implantation and reduce the risk of tricuspid ring damage in a patient recently treated with tricuspid ring annuloplasty.
1
Case presentation
A 72-year-old woman underwent elective mitral valve replacement (29 mm St. Jude Epic) and tricuspid ring annuloplasty (28 mm Edwards MC3). In the first 24 h following cardiac surgery, she experienced progressive systolic impairment of the right ventricle (RV) that did not respond to inotropic support, intra-aortic balloon pump counterpulsation (IABP) and fluid administration. We therefore proceeded to RV Impella® RP (Abiomed Inc., Danvers, MA) implantation to support RV recovery . (See Fig. 1 .)
