The Buddy-Wire Technique for Impella RP Placement: A Case Report

Although Impella RP has long been used in acute right ventricular failure, the use of parallel stiff and soft wires ("buddy-wire" technique) for its placement has rarely been described. A 70-year-old man with a left ventricular assist device was found to be in a ventricular tachycardia storm following a firing of his defibrillator. Due to unsuccessful cardioversion, he underwent implantation of an Impella RP. The latter was proven challenging due to the presence of a defibrillator lead; however, the implementation of the buddy-wire technique facilitated its passage, rendering it as a potential solution for patients with complex cardiac anatomies.