Post-Operative RV Failure and Hemodynamic Support with Impella RP

February 5, 2018

Dr. Peter Monteleone joins Dr. George Vetrovec to discuss a case involving Impella RP for right ventricular support in immediate post-operative RV failure. RV dysfunction and failure is a known complication at the time of post-operative weaning from cardiopulmonary bypass. Dr. Monteleone discusses the etiology of RV failure and the available treatment options.

The case review involves a 72 year old patient with heart failure AV stenosis who underwent surgical AVR and MVr. The surgical procedure went well and upon being removed from cpb, she developed systemic hypotension, elevated CPV, RV dilation in surgical view. Inotropes were initiated with some stabilization of blood pressure, though no improvement in RV hemodynamics. The team then decided to implant the Impella RP using micropuncture and ultrasound for access. Once the device was initiated, the team saw immediate PA pressure increase with improvement of PA pulse pressures, RV dilation improved within minutes, CPV decreased, and system pressure improved with down-titration of inotropic support.

Learn more about the Impella RP and right ventricular circulatory support.

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