Pearls and Pitfalls of Epicardial Echocardiography for Implantation of Impella CP Devices in Ovine Models

Konstantin Yastrebov; Laurencie M Brunel; Fiona C Schnitzler; Lisa M Partel; Hugh S Paterson; Paul G Bannon

doi:10.1007/s12265-024-10555-1

Pearls and Pitfalls of Epicardial Echocardiography for Implantation of Impella CP Devices in Ovine Models

J Cardiovasc Transl Res. 2024 Sep 10. doi: 10.1007/s12265-024-10555-1. Online ahead of print.

Authors

Konstantin Yastrebov^{1

2}, Laurencie M Brunel^{3

4}, Fiona C Schnitzler⁵, Lisa M Partel³, Hugh S Paterson^{4

5}, Paul G Bannon^{3

4

5}

Affiliations

¹ Sydney Imaging Core Research Facility, The University of Sydney, Camperdown, 2006, Australia. syastrebov@y7mail.com.
² University of New South Wales, Randwick, Sydney, Australia. syastrebov@y7mail.com.
³ Sydney Imaging Core Research Facility, The University of Sydney, Camperdown, 2006, Australia.
⁴ The Baird Institute of Applied Heart and Lung Surgical Research, Sydney, Australia.
⁵ Sydney Medical School, University of Sydney, Camperdown, Australia.

PMID: 39256288
DOI: 10.1007/s12265-024-10555-1

Abstract

The Impella CP is a percutaneously inserted temporary left ventricular assist device used in clinical practice and in translational research into cardiogenic shock, perioperative cardiac surgery, acute cardiac failure and mechanical circulatory support. Fluoroscopic guidance is usually used for insertion of an Impella, thus limiting insertion to within catheterization laboratories. Transthoracic, transoesophageal and intracardiac echocardiography have been reported to guide Impella CP implantation with identified specific limitations stemming from the surgical, anatomical and equipment factors. We conducted translational prospective descriptive feasibility investigation as a part of two other hemodynamic Impella studies. It showed the successful application of epicardial echocardiographic scanning for implantation of Impella CP devices in ovine models, from which details of the technique and identified pitfalls are described with practical solutions for future investigators and clinicians. Many described findings are relevant to any other echocardiographic techniques when adequate imaging of the Impella and relevant anatomical structures is achievable.

Keywords: Cardiac surgical procedures. Temporary left ventricular assist device; Epicardial echocardiography; Ovine model.