Use of the Impella device in ambulatory heart failure and pre-heart transplant patients - one medical center’s experience

Abstract

Background and objective: The prevalence of heart failure (HF) in the US has increased over several years. The American Heart Association (AHA) documents that HF has a prevalence of 6 million cases among Americans aged 20 years and older. HF is a complex syndrome that results from the structural or functional impairment of ventricular filling or ejection of blood, leading to symptoms including poor exercise tolerance, shortness of breath, and signs of HF such as edema and rales. The aim of the study was to add to the knowledge base from one medical center's experience using Impella device in ambulatory heart failure and pre-heart transplant patients.

Results: The axillary Impella enables HF patients to ambulate inside the CICU while waiting for destination therapy. RNs in our medical center's CICU can take care of these patients effectively and competently because of extensive prior experiences with the AxIABP. Nursing staff have adapted existing nursing procedures, protocols, and lessons learned from experiences with the AxIABP to manage this new patient population.

Discussion: Impella is one treatment option in advanced HF and pre-heart transplant patients. The development of an alternative insertion technique that allows patients to ambulate instead of being on bedrest continues to evolve. Our medical center’s experiences with taking care of ambulatory HF and pre-heart transplant Impella patients have shown that this is a safe and effective treatment.