Impella® Skills Video: Mattress Suture Technique

This Impella skills video demonstrates the mattress suture technique.

1. Place a deep mattress suture at the venotomy site, but DO NOT secure it down. Abiomed recommends using a 0 or 2 “0” silk on a CT-1 needle.
2. While monitoring position of the Impella RP® under fluoroscopy, completely remove the 23Fr peel-away introducer from the body while applying manual pressure just above the puncture site to control hemostasis.
3. Grasp the two wings of the peel-away introducer and bend back until the valve assembly comes apart. Continue to peel away the introducer until it is completely separated from the catheter shaft.
4. Slide the repositioning sheath into the femoral vein so that the yellow hub is at skin level.
5. Tie down the mattress suture. Light manual pressure may be needed for hemostasis while securing the mattress suture.
6. Maintain manual pressure for an additional 10 to 15 minutes or until hemostasis is achieved.
7. Attach the anticontamination sleeve to the yellow hub of the repositioning sheath.
8. Lock the anchoring ring in place by turning it clockwise.
9. Carefully extend the anticontamination sleeve to maximum length and secure the end closest to the blue Impella plug by tightening the anchoring ring.