Abstract
Impella is a device effective for the treatment of cardiogenic shock. However, among small children, its application has limitations due to left ventricle size and vasculature and the turning diameter of the aortic arch. Herein, we report an 11-year-old girl with fulminant myocarditis who was successfully managed with Impella CP implantation via the right subclavian artery using a polyethylene terephthalate chimney graft. Compared with insertion via the femoral artery, this method has several advantages. That is, it can address limitations in aortic arch diameter and facilitate equable fixation of the Impella device in small pediatric patients.
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Acknowledgements
We thank Dr. Akazawa, Department of Cardiology, Osaka University Graduate School of Medicine, for technical support for Impella insertion.
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All authors participated in the medical care of the patient and the establishment of the study design. MH, TK, and HI wrote the manuscript. JN, RI, TK, TW, MT, TU, KO, and SM revised the manuscript. All authors approved the final version of the manuscript.
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The authors declare that they have no conflict of interest.
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This retrospective case study was approved by the research ethical committee of Osaka University Hospital (no. 19266), and a written informed consent was obtained from the parents of the patient.
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Hirose, M., Ishida, H., Kawamura, T. et al. Trans-subclavian approach for Impella CP implantation using the chimney graft in a pediatric patient with fulminant myocarditis during extracorporeal support. J Artif Organs 26, 242–245 (2023). https://doi.org/10.1007/s10047-022-01369-6
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DOI: https://doi.org/10.1007/s10047-022-01369-6