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User Manual

AXILLARY INSERTION OF THE IMPELLA

5.5

CATHETER

NOTE – Proper surgical procedures and techniques are the

responsibility of the medical professional. The described

procedure is furnished for information purposes only. Each

physician must evaluate the appropriateness of the procedure

based on his or her medical training and experience, the type of

procedure, and the type of systems used.

If the Impella Catheter is used in the OR as part of open heart surgery,

manipulation may be performed only at the access site. Direct manipulation

of the catheter assembly through the aorta or ventricle may result in serious

damage to the Impella Catheter and serious injury to the patient.
When using a pigtail diagnostic catheter with side holes, ensure that the

guidewire exits the end of the catheter and not the side hole. To do so,

magnify the area one to two times as the guidewire begins to exit the pigtail.
During placement of the Impella Catheter, take care to avoid damage to the

inlet area while holding the catheter and loading the placement guidewire.

The introducer and graft lock are supplied sterile and can be used only if

the packaging is not damaged and the expiration date has not elapsed.

Fluoroscopy is required for the insertion of the Impella guidewire and

Impella Catheter.
During insertion, avoid manual compression of the inlet or outlet areas of

the Impella Catheter or the sensor area of the cannula on the Impella 5.5

with SmartAssist Catheter.
The graft must be affixed to the introducer proximal to the retainers on the

introducer repositioning unit to prevent the introducer from sliding out of the

graft.
When inserting the Impella Catheter through the introducer and into

the graft, be sure to clamp the graft with a vascular clamp just above

the anastomosis to avoid blood loss through the pump cannula during

insertion through the valve.
The Impella Axillary Insertion kit is intended to be used for insertion only.

To provide continued hemostasis, the introducer must be peeled away and

the repositioning unit inserted into the graft.
Do

NOT

resterilize or reuse any components of the Impella Axillary

Insertion kit. All components are disposable and intended for single use

only. Reuse, reprocessing, or resterilization may compromise performance.
The introducer is designed to be inserted into a graft. It is not intended for

direct insertion into the artery.
Abiomed recommends the use of a 10 mm diameter Hemashield Platinum

graft with the introducer for proper fit and hemostasis between the graft

and the introducer. A smaller diameter graft may not fit over the introducer.
Abiomed recommends the use of a 20 cm length graft to allow enough

length to fully insert the Impella Catheter cannula into the graft prior

to releasing vascular clamps at the anastomosis to minimize blood loss

through the cannula.
Do

NOT

kink or clamp the white portion of the Impella Catheter with cm

markings with anything other than a soft jaw vascular clamp.

NOT

kink or clamp the peel-away introducer.

Proper positioning of the Impella Catheter is extremely important and it is

worthwhile to take extra time when positioning the catheter.

Take care to insert the guidewire with diagnostic catheter into the middle

of the hemostatic valve of the introducer to avoid tearing the valve.

When inserting the Impella Catheter into the introducer, take care to

insert it straight into the center of the introducer valve.

Be sure that the stopcock on the peel-away introducer is always kept in the

closed position. Significant bleed back can result if the stopcock is open.

The following steps describe the recommended technique for axillary artery

insertion of the Impella 5.5

with SmartAssist

Catheter.

Isolate and expose the axillary artery and obtain control via proximal and

distal vessel loops.

Attach a 10 mm diameter x 20 cm long vascular graft to the axillary

artery using a standard end-to-side anastomosis.

NOTE:

Abiomed

recommends using a Hemashield Platinum graft and recommends using

at least a 60 degree bevel on the end of the graft to facilitate passage of

the rigid motor housing into the artery.

Clamp the graft with a vascular clamp just above the anastomosis and

loosen the vessel loops to allow blood to flow into the graft to assess for

hemostasis at the anastomosis.

Insert the introducer into the graft and secure it with one (1) provided

graft lock. To place the graft lock, open it and place it between the

retainers and the hub on the introducer to prevent the introducer from

sliding out of the graft.

NOTE:

If a graft other than the Hemashield

Platinum is used, two graft locks may be required to maintain hemostasis

between the graft and the introducer. Correct positioning of the second

graft lock is illustrated in below.

Introducer, Graft Lock, and Hemashield Platinum Graft (Graft Not Supplied)

Correct Positioning If Second Graft Lock Required

Secure the graft lock by pressing both the outside tabs together. When

fully closed, the graft lock provides hemostasis. If hemostasis

is not achieved, make sure to press the two tabs together to fully close

the graft lock as shown below. The graft lock cannot be damaged by

over closing.

NOTE:

The graft may also be secured over the introducer

using heavy sutures or umbilical tape.

Closing the Graft Lock

Содержание Impella 5.5

Страница 1: ...USER MANUAL BENUTZERHANDBUCH MANUALE D USO MANUEL D UTILISATION U IVATELSK P RU KA Impella 5 5 with SmartAssist Circulatory Support System...

Страница 2: ...TABLE OF CONTENTS English 1 Deutsch 17 Italiano 35 Fran ais 53 esky 69...

Страница 3: ...es to the patient An MRI may also damage the electronics of the Impella 5 5 System During defibrillation do NOT touch the Impella 5 5with SmartAssist Catheter cables or Automated ImpellaController Avo...

Страница 4: ...5 5 Catheter is inserted via axillary artery cut down through the artery and into the left ventricle The Impella 5 5 Catheter may also be surgically inserted when there is access to the ascending aor...

Страница 5: ...length peel away introducer and two 2 graft locks used to attach a graft onto the introducer Note Only one graft lock is required when used with the recommended Hemashield Platinum graft a back up is...

Страница 6: ...essing the MENU soft key 2 The controller displays the screen shown below INSERT PURGE CASSETTE 1 Open the purge cassette package 2 Secure the yellow luer connector on the purge tubing to the sterile...

Страница 7: ...creen Note The default purge fluid values will be the purge fluid values from the last Case Start performed on a given Automated Impella Controller 3 To change the purge fluid information press the ED...

Страница 8: ...ucer A smaller diameter graft may not fit over the introducer Abiomed recommends the use of a 20 cm length graft to allow enough length to fully insert the Impella Catheter cannula into the graft prio...

Страница 9: ...essary to pull the introducer over the repositioning sheath to remove the peel away completely from the artery 15 To remove the introducer release the graft lock by pressing the two adjacent long tabs...

Страница 10: ...CT AORTIC INSERTION NOTE Proper surgical procedures and techniques are the responsibility of the medical professional The described procedure is furnished for information purposes only Each physician...

Страница 11: ...theter position in the aortic arch If there is slack in the catheter loosen the Touhy Borst remove the excess slack and RE TIGHTEN THE TUOHY BORST The catheter should align against the lesser curvatur...

Страница 12: ...appears first when a suggested adjustment is calculated If a suggested adjustment is calculated then a second notification will appear after 24 hours of pump use To adjust LV Placement Signal 1 Press...

Страница 13: ...inder will also be displayed to update the CO if the Automated Impella Controller detects a significant change in the vascular state This notification will be triggered if the average NCO or PP diverg...

Страница 14: ...bing is NOT kinked Select NEXT to continue 4 Disconnect the purge tubing from the Impella Catheter 5 Confirm that no air remains in the purge tubing If air remains press BACK to repeat the air removal...

Страница 15: ...otor is at least 3 cm from the sensors in the mapping catheter however do NOT pull the inlet area out of the left ventricle 3 Ensure that the Impella Catheter is operating at P 1 P 5 or P 7 as these P...

Страница 16: ...n the MNS magnets are in the Navigate position The displayed flow will be accurate when the MNS magnets are in the Stowed position ALARMS OVERVIEW The Automated ImpellaController monitors various func...

Страница 17: ...2019 11 06 Do not reuse Sterilized using ethylene oxide Medical Device Do Not Flush Do NOT flush Glucose Use glucose in the purge fluid IMPELLA 5 5 CATHETER PARAMETERS Speed range 0 to 33 000 rpm Pow...

Страница 18: ...Catheter is disposable and must be disposed of in accordance with hospital regulations for blood contaminated materials The Automated ImpellaController is marked according to Directive 2012 19 EU Devi...

Страница 19: ...onenten des Impella 5 5 Systems nicht mehr funktionieren und zu Verletzungen des Patienten f hren Ein MRT kann zudem die Elektronik des Impella 5 5 Systems besch digen Ber hren Sie w hrend einer Defib...

Страница 20: ...ms Der Impella 5 5 Katheter wird ber einen Cut Down der Arteria axillaris durch die Arterie und in den linken Ventrikel eingef hrt Der Impella 5 5 Katheter kann auch chirurgisch ber einen direkten Zug...

Страница 21: ...zwei 2 Graft Klemmen f r die Befestigung eines Transplantats auf der Einf hrhilfe Hinweis F r die Verwendung mit dem empfohlenen Hemashield Platinum Transplantat ist nur 1 Graft Klemme erforderlich ei...

Страница 22: ...ler zeigt den unten gezeigten Bildschirm an PURGEKASSETTE EINLEGEN 1 ffnen Sie die Verpackung der Purgekassette 2 Sichern Sie den gelben Luer Anschluss an der Purgeleitung am Sterilfeld 3 Geben Sie di...

Страница 23: ...ildschirm ge ffnet Hinweis Die Standardwerte f r die Purgefl ssigkeit sind die Purgefl ssigkeitswerte vom letzten Fallstart der auf dem Automated Impella Controller durchgef hrt wurde 3 Dr cken Sie zu...

Страница 24: ...hrhilfe Abiomed empfiehlt die Verwendung eines Transplantats mit 20 cm L nge damit es lang genug ist um die Impella Katheterpumpen Kan le darin einzusetzen bevor die Gef klemmen an der Anastomose fre...

Страница 25: ...23F x 6 cm muss die Einf hrhilfe m glicherweise ber die Repositionierungsschleuse gezogen werden um die Peel Away Einf hrhilfe vollst ndig von der Arterie zu entfernen 15 L sen Sie zum Entfernen der...

Страница 26: ...k bis eine Aortenkurve auf dem Platzierungsbildschirm angezeigt wird b Wenn die Aortenkurve vorliegt ziehen Sie den Katheter f r Impella 5 5 mit SmartAssist um weitere 3 cm zur ck Der Abstand zwischen...

Страница 27: ...e aortales Platzierungssignal aus Stellen Sie sicher dass der vordere Stopfen nicht ber die Basis des Transplantats hinaus vordringt 13 Um die Passage des Katheters zu erleichtern wenden Sie leichten...

Страница 28: ...20 000 P 4 1 9 3 3 22 000 P 5 2 8 3 7 24 000 P 6 3 4 4 1 26 000 P 7 3 9 4 5 28 000 P 8 4 3 4 9 30 000 P 9 5 0 5 5 33 000 Die Flussrate kann aufgrund von Ansaugen oder falscher Positionierung variiere...

Страница 29: ...kann 4 Um den Vorgang abzuschlie en dr cken Sie die Soft Taste FERTIG oder den Drehknopf Eine Herzzeitvolumen Best tigung wird angezeigt wenn ein Gesamt Herzzeitvolumen eingegeben wird das kleiner ode...

Страница 30: ...Trennen des Luer Anschlusses abgeschlossen sein Der Impella Katheter kann besch digt werden wenn der Austausch nach dem Trennen des Luer Anschlusses mehr als 90 Sekunden in Anspruch nimmt 4 ffnen Sie...

Страница 31: ...P Level auf P 2 verringert worden ist belassen Sie den Patienten auf P 2 Unterst tzung bis seine H modynamik stabil ist bevor Sie die Kreislaufunterst tzung beenden 3 Wenn die H modynamik des Patient...

Страница 32: ...en bei der Abw gung der Risiken und des Nutzens der Verwendung des Impella Systems ohne Heparin einsetzen Wenn es im besten Interesse des Patienten ist das System ohne Heparin zu verwenden muss die Gl...

Страница 33: ...zu hoch zu sein oder MNS Magnete Gestaut Angezeigte Tropfen Der angezeigte Fluss des Impella Katheters wird k nstlich erh ht wenn die MNS Magnete sich in der Position Navigieren befinden Der angezeigt...

Страница 34: ...5 Katheter Klassifizierung gem Richtlinie 93 42 EWG Klasse III Latexfrei Ja SYMBOLE Vorsicht Gebrauchsanweisung beachten Defibrillatorsicheres CF Ger t Trocken lagern 10 C 30 C Lagertemperatur z B 10...

Страница 35: ...zum Einmalgebrauch vorsehen und muss gem den Krankenhausrichtlinien f r mit Blut kontaminierte Materialien entsorgt werden Der Automated Impella Controller ist gem der Richtlinie 2012 19 EU gekennzeic...

Страница 36: ...Gebrauchsanweisung 34...

Страница 37: ...nte la defibrillazione NON toccare il catetere Impella i cavi o il controller automatizzato Impella Evitare l inserimento eccessivo del catetere Impella 5 5 e possibilmente di far urtare la punta del...

Страница 38: ...5 5 inserito mediante taglio dell arteria ascellare attraverso l arteria e nel ventricolo sinistro Il catetere Impella 5 5 pu essere inserito chirurgicamente anche quando si ha accesso all aorta asce...

Страница 39: ...ghezza e due 2 fermi per innesto utilizzati per fissare un innesto sull introduttore Nota richiesto un unico fermo per innesto se utilizzato con l innesto raccomandato Hemashield Platinum fornito un r...

Страница 40: ...U 2 Il controller visualizza la schermata mostrata di seguito INSERIRE LA CASSETTA DI SPURGO 1 Aprire la confezione della cassetta di spurgo sul campo sterile 2 Fissare al campo sterile il connettore...

Страница 41: ...hermata successiva Nota I valori predefiniti per il fluido di spurgo saranno quelli dell ultimo Avvio procedura eseguito su Automated Impella Controller 3 Per modificare i dati del fluido di spurgo pr...

Страница 42: ...ttarsi all introduttore Abiomed consiglia l uso di un innesto di 20 cm di lunghezza per consentire una lunghezza sufficiente a inserire completamente la cannula del catetere Impella nell innesto prima...

Страница 43: ...te sigillato sull innesto e sul catetere da 9 Fr aprire la valvola di lavaggio del braccio laterale sull introduttore e verificare che il sangue non fuoriesca dal sistema 14 Arretrare la guaina di rip...

Страница 44: ...lare piuttosto che una forma d onda aortica seguire i passaggi a c riportati di seguito a Tirare indietro il catetere fino a quando una forma d onda aortica non presente sulla schermata di posizioname...

Страница 45: ...tto anteriore di avanzare oltre la base dell innesto 13 Per aiutare a far passare il catetere attraverso la valvola aortica applicare una leggera pressione sulla parte posteriore della valvola aortica...

Страница 46: ...menu CONTROLLO PORTATA 2 Ruotare la manopola di selezione per aumentare o ridurre la portata 3 Premere la manopola di selezione per selezionare la nuova portata REGOLAZIONE DEL SEGNALE DI POSIZIONAMEN...

Страница 47: ...a conferma della gittata cardiaca Figura sotto Il pulsante a sfioramento CONFERMA utilizzer il Flusso Impella corrente poich l immissione della gittata cardiaca nativa e della gittata cardiaca totale...

Страница 48: ...go quando si chiude lo sportello 7 Confermare che il luer scollegato Premere AVANTI per procedere alla preparazione della cassetta di spurgo 8 Aggiornare le informazioni del fluido di spurgo a Per sel...

Страница 49: ...chiusura della protesi vascolare prendere in considerazione le caratteristiche individuali del paziente e scegliere la strategia pi idonea a conseguire risultati clinici ottimali Se indicato possibile...

Страница 50: ...o sinistro 3 Assicurarsi che il catetere Impella funzioni a P 1 P 5 o P 7 poich tali livelli P causano la minima interferenza SISTEMI DI NAVIGAZIONE MAGNETICA SNM Esempio di SNM Sistema di navigazione...

Страница 51: ...fondo bianco Grave Situazione anomala Richiesta azione sollecita 3 segnali acustici ogni 15 secondi Testo dell allarme su sfondo giallo Critico Priorit elevata Richiesta azione immediata 10 segnali ac...

Страница 52: ...parina pari a 25 o 50 IU per ml Dal 5 al 20 300 1100 mmHg 2 28 ml h Durata massima di utilizzo UE Affidabilit Fino a 30 giorni 91 4 con confidenza dell 80 a 30 giorni in base al test chi quadro Dimens...

Страница 53: ...oli monouso che devono essere smaltiti in conformit alle norme ospedaliere per i materiali contaminati da sangue L Automated Impella Controller conforme alla direttiva 2012 19 EU I dispositivi venduti...

Страница 54: ...Manuale utente 52...

Страница 55: ...la et provoquer des blessures chez le patient Une IRM peut galement endommager les circuits lectroniques du syst me Impella Pendant une d fibrillation ne touchez PAS le cath ter Impella les c bles ou...

Страница 56: ...mpella 5 5 est ins r via une incision art rielle axillaire par l art re et dans le ventricule gauche Le cath ter Impella 5 5 peut galement tre ins r par intervention chirurgicale en cas d acc s l aort...

Страница 57: ...our greffe permettant de fixer une greffe sur l introducteur Remarque Un seul dispositif de verrouillage pour greffe est n cessaire lors d une utilisation avec la greffe Hemashield Platinum recommand...

Страница 58: ...S RER LA CASSETTE DE PURGE 1 Ouvrez l emballage de la cassette de purge sur le champ st rile 2 Fixez le connecteur Luer jaune sur le tuyau de purge sur le champ st rile 3 Sortez la cassette de purge p...

Страница 59: ...d faut du liquide de purge seront les valeurs du liquide de purge du dernier d but de traitement effectu sur l Automated Impella Controller 3 Pour modifier les informations sur le solut de purge appuy...

Страница 60: ...permettre l insertion compl te de la canule du cath ter Impella dans la greffe avant de rel cher les clamps vasculaires au niveau de l anastomose afin de minimiser la perte de sang par la canule Ne p...

Страница 61: ...e compl tement le greffon et le cath ter 9 Fr ouvrez la valve de rin age du bras lat ral de l introducteur et v rifiez que le sang ne fuit pas du syst me 14 Glissez la gaine de repositionnement sur le...

Страница 62: ...a 5 5 avance trop loin dans le ventricule gauche et que le contr leur affiche une forme d onde ventriculaire plut t qu aortique proc dez comme suit a Tirez le cath ter vers l arri re jusqu ce qu une o...

Страница 63: ...on 13 Pour faciliter le passage du cath ter travers la valve aortique appliquez une l g re pression sur la partie post rieure de la valve aortique pour provoquer une insuffisance aortique temporaire 1...

Страница 64: ...0 0 0 P 1 0 12 000 P 2 0 0 1 9 17 000 P 3 1 1 2 7 20 000 P 4 1 9 3 3 22 000 P 5 2 8 3 7 24 000 P 6 3 4 4 1 26 000 P 7 3 9 4 5 28 000 P 8 4 3 4 9 30 000 P 9 5 0 5 5 33 000 Le d bit peut varier en raiso...

Страница 65: ...tuel Figure ci dessous Le bouton programmable CONFIRMER utilisera le d bit Impella actuel puisque l entr e de d bit cardiaque total et le d bit cardiaque natif ne feront pas l objet d une tendance Le...

Страница 66: ...econdes apr s la d connexion du luer 7 V rifiez que le raccord Luer est d branch Appuyez sur SUIVANT pour passer l amor age de la cassette de purge 8 Mettez jour les informations relatives au liquide...

Страница 67: ...iques individuelles de chaque patient et choisissez la strat gie qui est susceptible de produire un r sultat clinique optimal Si indiqu l int gralit du greffon vasculaire peut tre retir e mais cela n...

Страница 68: ...h ter de cartographie Si vous suspectez des interf rences respectez les tapes de d pannage indiqu ci dessous Observation Actions Interf rence avec le composant de d tection des emplacements magn tique...

Страница 69: ...est r solue avant que vous n appuyiez sur SILENCE ALARME Le message visuel reste cependant affich avec l en t te de l alarme sur fond gris pendant 20 minutes ou jusqu ce que vous appuyiez sur SILENCE...

Страница 70: ...usqu 30 jours 91 4 avec 80 de confiance 30 jours selon le test du Chi carr Dimensions du cath ter Longueur du segment invasif sans cath ter Diameter Motor Diameter Cannula 114 mm 18 Fr 6 3mm 21 Fr 7 m...

Страница 71: ...odukovan p strojem MRI m e zp sobit e komponenty syst mu Impella p estanou pracovat co povede k poran n m pacienta MRI tak m e po kodit elektroniku syst mu Impella B hem defibrilace se NEDOT KEJTE kat...

Страница 72: ...tr Impella 5 5 se zav d p es preparaci axil rn tepny skrze tepnu a do lev komory Kat tr Impella 5 5 se tak m e chirurgicky zav st kdy existuje p stup k vzestupn aort prost ednictv m sternotomie nebo...

Страница 73: ...Assist p es axil rn tepnu Obsahuje odtrh vac zavad o pr m ru 23 Fr a d lce 6 cm a dva 2 zaji ovac prvky t pu kter se pou vaj k p ipevn n t pu na zavad POZN MKA P i pou it s doporu en m platinov m t pe...

Страница 74: ...t n p padu lze tak zvolit stisknut m softwarov ho tla tka NAB DKA 2 dic jednotka zobraz obrazovku uvedenu n e VLO EN PROPLACHOVAC KAZETY 1 Otev ete obal proplachovac kazety na steriln pole 2 Zajist te...

Страница 75: ...odnoty a automaticky se p ejde na dal obrazovku POZN MKA V choz hodnoty proplachovac tekutiny budou hodnoty proplachovac tekutiny z posledn ho spu t n p padu proveden ho na jednotce Automated Impella...

Страница 76: ...lku pro pln zaveden kanyly kat tru Impella do t pu p ed uvoln n m c vn ch svorek u anastom zy aby se minimalizovala ztr ta krve kanylou NEZALAMUJTE ani NESVORKUJTE b lou st kat tru Impella s cm zna ka...

Страница 77: ...zaji ovac prvek t pu stisknut m dvou sousedn ch dlouh ch v stupk k sob jak je zn zorn no n e a vyjm te jej ze t pu Uvoln n zaji ovac ho prvku t pu 16 P ed odtr en m vysu te zavad pln ze t pu Chcete l...

Страница 78: ...Ka d l ka mus vyhodnotit vhodnost tohoto postupu a to na z klad sv ch profesion ln ch odborn ch znalost a zku enost typu postupu a typu pou it ho syst mu Vyvarujte se ru n ho stla ov n oblast vstupu v...

Страница 79: ...uku aorty Pokud m kat tr v li uvoln te Tuohy Borst odstra te tuto nadm rnou v li a ZNOVU UT HN TE TUOHY BORST Kat tr by m l b t vyrovn n v i men kurvatu e aorty sp e ne velk kurvatu e Ov te um st n s...

Страница 80: ...ktivn alarmy S n Nespolehliv sign l um st n nebo alarmy polohy Abnorm ln stavy v etn srde n arytmie rozpojen Ao LV nebo aort ln sten zy tak mohou omezovat u ite nost n stroje nastaven LV NASTAVEN SIGN...

Страница 81: ...kalibra n faktor jednotka Automated Impella Controller bude pokra ovat ve v po tu srde n ho v deje nativn ho srde n ho v deje a srde n ho v konu po dobu n sleduj c ch 8 hodin pomoc v e uveden ch rovn...

Страница 82: ...ipojte lut luer od proplachovac kazety ke kat tru Impella ODVZDU N N PROPLACHOVAC HO SYST MU Pro odvzdu n n proplachovac ho syst mu prove te tyto kroky 1 Stiskn te tla tko PROPLACH a zvolte mo nost O...

Страница 83: ...t tru Impella aby se zajistilo e motor Impella bude minim ln 3 cm od sn ma v mapovac m kat tru ale NEVYTAHUJTE vstupn oblast z lev komory 3 Zajist te aby kat tr Impella pracoval p i P 1 P 5 nebo P 7 p...

Страница 84: ...kdy jsou magnety MNS v poloze Navigace Zobrazen pr tok bude p esn kdy jsou MNS magnety v poloze Slo en P EHLED ALARM Kompletn seznam v ech alarm Impella najdete v dokumentu N vod k pou it Jednotka Au...

Страница 85: ...ou t p ed 2019 11 06 Nepou vat opakovan Sterilizov no etylenoxidem Zdravotnick prost edek Nevyplachovat NEVYPLACHOVAT Gluk za Pou it gluk zy v proplachovac tekutin PARAMETRY KAT TRU IMPELLA 5 5 Rozsah...

Страница 86: ...ov polo ky kter se mus zlikvidovat v souladu s nemocni n mi p edpisy pro materi ly kontaminovan krv Jednotka Automated Impella Controller je ozna ena v souladu se sm rnic 2012 19 EU Prost edky prod va...

Страница 87: ...85 Syst mu podpory krevn ho ob hu Impella 5 5 se SmartAssist ESKY...

Страница 88: ...1805 2246633 EU www abiomed com October 2021 Document No 0550 9000 rD 2021 ABIOMED Inc All rights reserved The ABIOMED logo and ABIOMED Impella Impella 2 5 Impella CP Impella CP with SmartAssist Impe...

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