Emergent Percutaneous Closure of a Free-Wall Perforation During Impella Implantation

Free wall perforation during percutaneous manipulation of devices and wires into the ventricular cavities is an uncommon but life-threatening complication that should be managed with emergent surgery whenever possible. However, the number of patients with prohibitive surgical risk that undergo complex percutaneous cardiac procedures is increasing. Some cases of ventricle perforation during Impella® (Abiomed; Danvers, MA) implantation have been previously reported but in all previous reported cases the patient underwent emergent surgery. We present a case of iatrogenic perforation during Impella® implantation that was emergently treated using an Amplatzer® Duct Occluder II device (Abbott Vascular; Santa Clara, CA).