The First Use of the Impella Microaxial VAD (R) Ventricular Assist Device in Our Country for Coronary Artery Bypass Surgery in the Beating Hart: Case Report

Abstract

Off-pump or minimally invasive cardiac surgery without the support of cardiopulmonary bypass (CPB) is becoming increasingly more important. Complete revascularisation of the occlused arteries is essential for better long term outcomes. A microaxial pump (Impella LD/LP, Abiomed, Aachen, Germany) placed in the left ventricle is effective in conditions when the main coronary arteries in the posterior cardiac wall can not be reached due to hemodynamic instability, or when switching from the planned off-pump strategy to the conventional cardiopulmonary bypass (on-pump) is not desired. For this reason, in such cases, microaxial intracardiac pump support. may provide hemodynamic stability by comfortably enabling complete revascularisation in the beating heart (off-pump). In this paper, we report the use of the Impella Microaxial VAD (R) in two high risk (EUROSCORE (R)) patients during coronary artery bypass operations in the beating heart for first time in our country.