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Updated: Oct 22, 2025

Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock

Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock

Published on: June 12, 2021

Impella insertion for residual aortic dissection.

Hisashi Yoshida¹, Yuki Ichihara¹, Ryogo Hoki¹

¹Department of Cardiovascular Surgery Tokyo Women's Medical University Tokyo Japan.

Clinical Case Reports

|August 30, 2021

Summary

Percutaneous heart pump insertion via the true lumen successfully managed acute aortic dissection with coronary malperfusion. Careful access site and device size selection are crucial for this complex cardiovascular intervention.

Keywords:

Impella aortic dissection post‐cardiotomy cardiogenic shock

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Area of Science:

Cardiovascular Surgery
Interventional Cardiology
Aortic Disease Management

Background:

Acute aortic dissection (AAD) with coronary malperfusion presents a critical surgical challenge.
Postoperative management for these patients is complex and requires advanced hemodynamic support.
Residual dissection after aortic graft replacement can complicate further interventions.

Observation:

A case of successful percutaneous heart pump (Impella) insertion is presented.
The device was inserted through the intact true lumen in a patient with residual aortic dissection post-graft replacement.
This approach was utilized to manage coronary malperfusion secondary to the aortic dissection.

Findings:

The percutaneous Impella insertion through the true lumen was technically successful.
This intervention effectively addressed the coronary malperfusion in the context of residual aortic dissection.
Hemodynamic stability was achieved, facilitating patient management.

Implications:

This case demonstrates a viable strategy for managing complex aortic dissection with malperfusion.
It highlights the importance of meticulous pre-procedural evaluation of the access site and appropriate device sizing.
This approach may offer a life-saving option for select patients with challenging cardiovascular conditions.