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The impella device was not received from the customer.Therefore, the investigation of the device was not possible.Should the device or any new information be received, a supplemental manufacturer device report will be filed.As noted in the impella instructions for use: impella rp smart assist system with automated impella controller section: warnings & cautions: cautions ¿dilators and catheters should be removed slowly from the sheath.Rapid removal may damage the valve, resulting in blood flow through the valve.¿ section: warnings & cautions: warnings ¿to reduce the risk of cardiac or vascular injury (including perforation) when manipulating the heart during cardiac surgery, evaluate the position of the pump using imaging guidance prior to manipulating the heart, and monitor position.¿ ¿to reduce the risk of cardiac or vascular injury (including perforation) when manipulating the heart during cardiac surgery, evaluate the position of the pump using imaging guidance.¿ section: warnings & cautions: warnings section: pre-support evaluation section: axillary insertion of the impella 5.5 catheter section: direct aortic insertion section: use of impella with transcatheter aortic valves ¿to reduce the risk of cardiac or vascular injury (including ventricular perforation) physicians should exercise special care when inserting the impella catheter in patients with complex anatomy.This includes patients with known or suspected: decreased ventricular cavity size, ventricular aneurysms, thin-walled ventricles due to chronic dilation, congenital heart disease, or compromised cardiac tissue quality.¿ ¿to reduce the risk of cardiac or vascular injury (including ventricular perforation) when advancing or torquing the impella, adjustments should be performed under imaging guidance.¿ section: warnings & cautions: warnings: ¿physicians should exercise special care when inserting the impella catheter during active cardiopulmonary resuscitation (cpr).In addition, active cpr maneuvers may change the position of the impella device, introducing the risk of cardiac or vascular injury (including ventricular perforation).Check that the pump is positioned correctly after cpr with chest x-ray guidance.¿ section: potential adverse events (united states).¿arrhythmia, atrial fibrillation, bleeding, cardiac tamponade, cardiogenic shock, death, device malfunction, hemolysis, hepatic failure, insertion site infection, perforation, phlegmasia cerulea dolens (a severe form of deep venous thrombosis), pulmonary valve insufficiency, respiratory dysfunction, sepsis, thrombocytopenia, thrombotic vascular (non-central nervous system complication, tricuspid valve injury, cardiac or vascular injury (including ventricular perforation), venous thrombosis, ventricular fibrillation and/or tachycardia.¿.
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