Implanting Impella 5.5 under Local Anesthesia.

Area of Science:

• Cardiology
• Cardiac Surgery
• Anesthesiology

Background:

• The Impella 5.5 device provides vital cardiac support and left ventricular unloading for heart failure patients.
• Current Impella 5.5 implantations typically require general anesthesia (GA).

Purpose of the Study:

• To evaluate the feasibility and safety of surgically implanting the Impella 5.5 device using only local anesthesia (LAS).
• To explore an alternative anesthetic approach for hemodynamically unstable patients requiring cardiac support.

Main Methods:

• Three critically ill patients with acute heart failure and cardiogenic shock underwent Impella 5.5 implantation.
• The procedure was performed exclusively under local anesthesia (LAS), avoiding general or regional anesthesia.
• Implantations were accessed via the right axillary artery.

Main Results:

• All Impella 5.5 device implantations were successfully completed under LAS.
• Local anesthesia involved a 50:50 mixture of 2% mepivacaine and 1% ropivacaine.
• One patient required hematoma evacuation post-surgery; no other Impella-related complications occurred.

Conclusions:

• Surgical implantation of the Impella 5.5 device under LAS is a feasible and safe procedure.
• This approach offers a potential alternative to general anesthesia for select heart failure patients.
• Further studies are warranted, but initial results encourage the use of LAS for Impella 5.5 implantation.