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Case Reports
. 2022 Nov 16;4(23):101674.
doi: 10.1016/j.jaccas.2022.09.032. eCollection 2022 Dec 7.

Report of Accidental Anchoring of an Impella Device to a Perceval Bioprosthesis in a Patient

Taiyo Jinno  1 , Yasuyuki Kato  1 , Hidetaka Yamauchi  1 , Tsukasa Iwasaki  2 , Yusuke Date  1 , Shigeki Nishiyama  2 , Kenichi Sasaki  1 , Atsushi Shimizu  3 , Hiroshi Kiyama  1 , Toshiya Koyanagi  4
Affiliations
Case Reports

Report of Accidental Anchoring of an Impella Device to a Perceval Bioprosthesis in a Patient

Taiyo Jinno et al. JACC Case Rep. .

Abstract

We herein report a case in which we encountered complications when placing an Impella CP ventricular assist device (catheter-based ventricular assist device) in a patient with a Perceval bioprosthetic valve (sutureless valve). Specifically, the catheter-based ventricular assist device became anchored to the sutureless valve and needed to be removed under cardiopulmonary bypass. (Level of Difficulty: Advanced.).

Keywords: CPB, cardiopulmonary bypass; Impella device; Perceval bioprosthetic valve; TEE, transesophageal echocardiography; TTE, transthoracic echocardiography; catheter-based ventricular assist device; sutureless valve.

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Conflict of interest statement

The authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Figures

None
Graphical abstract
Figure 1
Figure 1
Structure of the Sutureless Valve Adapted with permission from the product information sheet supplied by Corcym (https://corcym.com/devices/aortic/US/perceval). STJ = sinotubular junction.
Figure 2
Figure 2
Transesophageal Echocardiographic Images of the Catheter-Based Ventricular Assist Device and Sutureless Valve Obtained Intraoperatively (A) Short-axis view of the ascending aorta. The catheter-based ventricular assist device is positioned outside the rings of the sutureless valve. (B) Long-axis view of the aortic valve. The catheter-based ventricular assist device is positioned outside the struts of the valve.
Figure 3
Figure 3
Fluoroscopic Images of the Catheter-Based Ventricular Assist Device and Sutureless Valve (A) Anteroposterior view. (B) Right anterior oblique view.
Figure 4
Figure 4
Interference Between the Catheter-Based Ventricular Assist Device Outlet and the Outflow Ring of the Sutureless Valve The interference between the catheter-based ventricular assist device outlet and the outflow ring of the sutureless valve is shown in the white circle. Reproduced with permission from product information supplied by Abiomed, Inc (https://www.abiomed.com/products-and-services/impella) and Corcym (https://corcym.com/devices/aortic/US/perceval).
Figure 5
Figure 5
Chest Radiograph Obtained Immediately After the Initial Surgery The catheter-based ventricular assist device is positioned too deeply, and the outlet of the catheter-based ventricular assist device is overlapping the struts of the sutureless valve.
Figure 6
Figure 6
Incorrect Passing of the Catheter Between the Aortic Wall and the Outflow Ring Gap between the outflow ring of the sutureless valve and the aortic wall at the sinusoidal junction level, through which the catheter-based ventricular assist device can accidentally be passed.
See this image and copyright information in PMC

References

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