Abiomed Impella 2.5, Instructions For Use Manual

Page: 84 / 211

5.30 Instructions for Use & Clinical Reference Manual (US)
Rear
Silicone
Plug
Front
Silicone
Plug
Figure 5.33 Impella
®
LD Catheter with Silicone Plugs
7.
With the graft clamped at the base, place the Impella
®
LD Catheter into the open end
of the graft up to the level of the rear plug.
8. When the catheter is in position, secure a tourniquet around the rear silicone plug.
Tighten the tourniquet sufficiently to control bleeding around the rear plug while still
allowing the catheter to slide through the plug.
9. Release the clamp and advance the Impella
®
LD Catheter into the aorta.
10.
If the patient is on cardiopulmonary bypass (CPB), allow the heart to fill by restricting
the return flow to the bypass machine and reducing CPB flow to a minimum setting, as
long as acceptable physiologic systemic flow is maintained.
11. As soon as the motor housing has passed into the aorta, use a ligature to loosely
secure the front silicone plug flush to the graft. The silicone plug should be in the most
proximal portion of the graft.
12.
While the catheter is being advanced in the aorta, the initial placement signal has the
characteristics shown in Figure 5.34. The inlet area of the catheter has not passed the
aortic valve. Do not allow the front plug to advance beyond the base of the graft.
Impella Flow
0.0
System Power
MUTE
ALARM
0 . 0
DISPLAY
0 . 0
MENU
PURGE
SYSTEM
Impella LD S/N: 123456
30 - 06 - 2011 05:30
100%
CONTROL
FLOW
P - 0
L/min
0.0 Max
________________________
0.0 Min
Purge System
Purge Pressure: 600 mmHg
Purge Flow: 20.0 ml/hr
Motor
Current
0/0
( 0)
( mA)
10 sec.
Placement
Signal
( mmHg)
6/2
( 2)
10 sec.
60
-20
1000
0
Figure 5.34 Waveform as Catheter is Advanced into the Aorta
13.
To aid in passing the catheter through the aortic valve, apply slight pressure to the
posterior aspect of the aortic valve to produce temporary aortic insufficiency.
Securing the Front
Silicone Plug
There should be no
movement of the front
silicone plug within the
graft; however, the catheter
shaft should move without
resistance within the plug.
When securing the front
silicone plug to the graft, do
not penetrate the silicone
plug too deeply as this could
cause damage to the Impella
®
LD Catheter.