[Microaxial Blood Pump Catheter( Impella) for Cardiogenic Shock]

Impella is a microaxial blood pump catheter, which could be placed in left ventricle( LV) from peripheral arteries and unload the LV by ejecting the blood from LV to the ascending aorta. It has been used as a less invasive LV assist device in more than 5,000 patients with cardiogenic shock in the last four and a half years since its approval in Japan. The first analysis of Japan Registry for Percutaneous Ventricular Assist Device (J-PVAD) in 819 patients demonstrated that combined use of Impella and veno-arterial extracorporeal membrance oxygenation (VA-ECMO) was applied in 47% and their 30 days survival was worse than single Impella support( 50% vs 81%) due to more profound shock status. Technical advances in less invasive mechanical circulatory support including new Impella 5.5 may play an important role in high-risk cardiac surgery.