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Straightening Misfolded Microaxial Flow Pump in the Aorta Using a Snare Catheter
Marko Šustić1, Tomislav Jakljević1, Zoran Miovski2
1Department of Cardiology, Clinical Hospital Center Rijeka, Rijeka, Croatia; Faculty of Medicine, Department of Internal Medicine, University of Rijeka, Rijeka, Croatia.
Background:
In patients with cardiogenic shock, misfolding of a microaxial flow pump within the aorta after deployment is a rare but serious complication that presents a significant therapeutic challenge.
Case Summary:
A 35-year-old woman was hospitalized with influenza myocarditis. Although initially hemodynamically stable, she developed cardiogenic shock 24 hours later, requiring implantation of an Impella CP device. She was transferred to the intensive care unit, where signs of device malfunction soon appeared. Fluoroscopy revealed a distorted, Z-shaped configuration of the Impella CP in the ascending aorta. Using a snare technique, the device was straightened in the descending aorta and successfully retrieved via the femoral sheath.
Discussion:
Currently, no established guidelines exist for managing microaxial flow pump misfolding. This case demonstrates a safe and effective percutaneous retrieval approach for this complication.
Take-Home Message:
The snare technique provides a safe and effective percutaneous method for retrieving a kinked microaxial flow pump device.
