Impella Education, Surgical Applications

Detailed Overview of Impella 5.5® with SmartAssist®, the Surgeon’s Heart Pump


Advanced Impella Trainer, Jason Richard, provides an overview of the Impella 5.5 with SmartAssist for physicians. Also known as the surgeon’s heart pump, the Impella 5.5 with SmartAssist has the ability to provide greater hemodynamic support, faster simplified setup in the operating room and greater confidence in positioning within the heart.

The Impella 5.5 with SmartAssist is designed for ease of insertion via the axillary artery or anterior aorta. It enables patient ambulation and is designed for longer duration of support with durable ceramic bearings and no pigtail. This minimally invasive weanable VAD provides forward flow with maximum unloading, enabling heart recovery with technology to intelligently identify the position of the pump and manage weaning.

Jason provides a deep dive into the Impella 5.5 with SmartAssist platform highlighting the following topics:

  • Tip-to-toe review of the Impella 5.5. with SmartAssist – new features, including the more rigid 21 Fr cannula, shorter 19 Fr motor, and optical pressure sensor, that improve deliverability and duration of support
  • Comparison of position monitoring between Impella 5.0® and Impella 5.5 with SmartAssist – distinguishing between the placement signal generated by the Impella 5.0 differential pressure sensor and the placement signal from the Impella 5.5 with SmartAssist optical sensor
  • Benefits of optical sensor in identifying position during position alarms
  • New repositioning guide that enables repositioning without imaging
  • Tips for optimizing Impella position to prevent migration and pump position alarms
  • Proper external fixation for preventing migration and catheter damage
  • Pump metrics overview – review of placement screen, including Ao and LV placement signals, total cardiac output and cardiac power output
  • SmartAssist hemodynamic sensors – optical pressure sensor that senses aortic pressure and microaxial motor that senses pressure difference between aorta and left ventricle
  • Improved troubleshooting for suction management – distinguishing between and appropriately treating intermittent diastolic suction and continuous suction
  • Adjusting the LV Placement Signal
  • Entering cardiac output
  • Trend screen overview – mean AO trend, LVEDP trend, total cardiac output, native cardiac output, and Impella® flow
  • Weaning guidance – 3 key steps with examples: 1. Look for stable MAP and LVEDP, 2. Assess native heart recovery, and 3. Maintain stable total cardiac output/cardiac power output


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