THE NOVEL RIGHT VENTRICULAR MICROAXIAL PUMP IMPELLA ENABLES SAFE HEART TRANSPLANTATION AFTER 24 HOURS ORGAN CONSERVATION

Purpose. Impaired contractility after long conservation times is a major problem after heart transplantation. A small and less invasive assist system could rescue the heart, reduce inotropes, and improve outcome.

Method. The new “Impella” is a miniaturized axial pump (diameter 19.2 F) for intracardiac support. It is introduced through a stab incision in the pulmonary artery with the top of the pump in the right ventricle.

Hearts of domestic pigs (n = 5) were transplanted after a cold ischemic time of 24 hours. After transplantation cardiopulmonary bypass was discontinued and right ventricular circulatory support maintained by the pump fur 5 hours.

Results. The new circulatory assist system provided stable hemodynamics. Introduction, handling and removal of the system was easy. One hour after weaning from the assist system hemodynamics remained stable.

Conclusions. The new right ventricular “Impella” system provides reliable mechanical support. This could open a new approach to the treatment of graft failure after heart transplantation, make longer conservation times feasible, and encourage the use of marginal donor hearts.

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