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The impella device was discarded by the customer, therefore, investigation of the device was not possible.Should the device or any new information be received, a supplemental mdr will be filed.Instructions for use for the related event are as follows: impella cp with smartassist system & impella 5.5 with smartassist for use during impella rp smart assist system with automated impella controller & rp flex with smart assist system with automated impella controller 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 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, congenital heart disease, or compromised cardiac tissue quality in the settings of acute infarction with tissue necrosis.¿ ¿to reduce the risk of vascular injury, physicians should exercise caution when inserting the impella catheter in patients with complex peripheral vascular anatomy.This includes patients with known or suspected: unrepaired abdominal aortic aneurysm, significant descending thoracic aortic aneurysm, dissection of the ascending/ transverse/descending aorta, chronic anatomical changes in the relationship of the aorta/aortic valve/ventricular alignment, significant mobile atheromatous disease in the thoracic or abdominal aorta or peripheral vessels.¿ ¿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 a risk of cardiac or vascular injury (including ventricular perforation).Check that the pump is positioned correctly in the left ventricle after cpr with echocardiography guidance.
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The complainant reported a patient was being implanted with an impella rp device for mechanical circulatory support.During implant, the physician had no issues gaining right femoral access for impella rp insertion but outlet unable to cross pv.The impella was pulled back and re-advanced, but cannula within right ventricle buckled over wire when advanced.After multiple attempts the rp insertion was aborted.
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