Abiomed Impella Manuel D'utilisation page 25

IMPELLA 2.5 OR IMPELLA CP CATHETER FULLY IN
VENTRICLE
If the Impella 2.5 or Impella CP Catheter is fully in the ventricle, the
following alarm appears:
Impella Position In Ventricle
In this situation, the placement screen will appear as shown below.
Impella CP Catheter Fully in Ventricle (similar to Impella 2.5)
Note: Yellow Flow Rate
If the Automated Impella Controller detects incorrect or unknown
catheter position, or if placement monitoring is suspended, the
flow rate in the flow area appears in yellow as shown in above.
Actions to take:
1.
Under fluoroscopic or echocardiographic guidance, reduce the
P-level to P-2 and carefully pull back the Impella Catheter until the
aortic waveform signal is showing.
2.
When you see the aortic waveform signal, pull the catheter back an
additional 4 cm
IMPELLA 2.5 OR IMPELLA CP CATHETER COMPLETELY
IN THE AORTA OR INLET AND OUTLET AREAS IN
VENTRICLE AND OPEN PRESSURE AREA IN AORTA
If the Impella 2.5 or Impella CP Catheter is completely in the aorta or if the
inlet and outlet areas are in the ventricle and the open pressure area is in
the aorta, the following alarm appears:
Impella Position Wrong
In this situation, the Placement Screen appears, as shown below.
Impella CP Catheter Completely in the Aorta or Inlet and
Outlet Areas in Ventricle and Open Pressure Area in Aorta
(similar for Impella 2.5)
Automated Impella Controller
Actions to take:
1.
Reduce the P-level to P-2 until imaging is available.
2. Under fluoroscopic or echocardiographic guidance, determine the
Impella Catheter position.
3. Return to preferred P-level and confirm positioning with imaging.
LOW NATIVE HEART PULSATILITY−IMPELLA 2.5 OR
IMPELLA CP
When a patient has poor native ventricular function, the placement signal
may remain pulsatile; however, the amplitude will be dampened.
In a situation of low native heart pulsatility, the Automated Impella
Controller may not be able to determine the catheter position. You may see
the following alarm appears:
Impella Position Unknown
Actions to take: Assess cardiac function.
IMPELLA CATHETER OUTLET AREA ON OR NEAR
AORTIC VALVE
If the Impella Catheter outlet area is on or near the aortic valve, the
catheter may be too deep in the ventricle.
Actions to take:
1. Assess and adjust Impella Catheter position under fluoroscopic or
echocardiographic guidance.
2.
If unsuccessful, reduce the P-level to P-2 and gently pull the
catheter back 2 cm to see if the condition resolves.
CATHETER POSITION WRONG−IMPELLA 5.0 OR LD
If the Impella 5.0 or LD Catheter is fully in the ventricle or fully in the aorta,
the following alarm will appear:
Impella Position Wrong
The Impella 5.0 or Impella LD System cannot differentiate between these
two conditions. In this situation, the placement screen will appear as
shown below.
Impella 5.0 Catheter Position Wrong (similar for Impella LD)
Actions to take:
1. Reduce the P-Level to P-2 until imaging is available.
2.
Reposition Impella Catheter under fluoroscopic or
echocardiographic guidance.
3.
Return to preferred P-Level and confirm positioning with imaging.
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