Case Review, Hemodynamics, Impella Education, Patient Management, AMI Cardiogenic Shock
Impella Connect® System and SmartAssist® Technology Facilitate Impella® Support in Cardiogenic Shock Case
Rajan Patel, MD, FACC, FAHA, FSCAI talks about Impella Connect® and SmartAssist® and how these new technologies benefits an Impella®-supported cardiogenic shock case. Dr. Patel is an interventional cardiologist and the interventional cardiology fellowship program director at Ochsner Medical Center in New Orleans, LA.
Dr. Patel presents a case of a 60-year-old male with anterior STEMI, who experienced ventricular fibrillation in the ED. Impella CP® was placed and the occluded proximal LAD was opened with balloon angioplasty and stented. The patient left the cath lab with a Swan-Ganz in place and Impella on P-9. For this case, Dr. Patel was using the new Impella console with the SmartAssist platform and had the ability to view new metrics: LVEDP, CO, and trends for each over time.
Dr. Patel explains how the SmartAssist platform enabled him to monitor cardiac output from Impella, from the native heart, and total cardiac output as the case progressed. “Once in the cardiac ICU, we were able to watch the patient’s LVEDP to help us assess the patient’s volume status. Additionally, we were able to assess our weaning of the Impella as we saw that cardiac output increased, mainly due to native cardiac output increasing. We could decrease our Impella P-level support and watch Impella power decrease and native cardiac performance increase.”
Dr. Patel tells interviewer Seth Bilazarian, MD, “Because the hemodynamic parameters are integrated into the Impella console, one can look at the trend over time, which I think is particularly important in managing these patients, especially when it comes to weaning, mechanical circulatory support, or sometimes needing escalation.”
Dr. Patel also discusses the benefits of Impella Connect, which enables clinicians to view Impella console data, through a secure website, on a laptop or mobile device. “When I’m in the cath lab or in the clinic, and a fellow or nurse calls me about the status of a patient, I can simply pull up the Impella Connect.” He explains that he can see if there are any alarms and look at CO and CPO to help him make decisions regarding the management of the patient without having to return to the bedside immediately. He emphasizes the remote benefits by telling Dr. Bilazarian, “I’ve been here in Boston today, and I’ve been monitoring a patient in New Orleans using Impella Connect.”