Week 1 impella Training

Question 1

Indications for Use

Answer 1

Protected PCI
-<4 hours 2.5&CP
For high-Risk PTCA’s elective or urgent, hemodynamically stable pts. w/ severe CAD, when Heart Team has determined.

Cardiogenic Shock
-2.5&CP <4hours
-<14 days LD&5.0
Ongoing shock post (<48hrs) AMI, Surgery, Cardiomyopathy (incl. Peripartum) or Myocarditis for isolated LVF not responsive to optimal Med. Mgmt.

Question 2

Contraindications

Answer 2

1. Mural Thrombus
2. Mech. Valve or LV Restrictive Device
3. AS 0.6 cm2 or less
4. Mod. to Severe AS >/= 2+
5. Severe peripheral disease
6. RHF *
7. Cardio respiratory failure *
8. ASD & VSD *
9. LV Rupture *
10. Cardiac tamponade *

Question 3

CPO formula AND Values

Answer 3

CO x MAP/451

Normal 1-1.5 watts

= 0.6 is sig. increased mortality
*strong correlate in shock pts.

Question 4

Impella Tip to Tail

Answer 4

Pigtail (CP 2-colored pig)
Inlet
Cannula
Outlet (Easy Lumen guide)
Motor 
OPP
Catheter shaft
Repositioning Unit
Red Impella plug
Clear sidearm (infusion filter, Pressure reservoir, Check valve)
Red pressure sidearm

Question 5

Impella 2.5
? French catheter

? French Repo Sheath

Answer 5

Impella 2.5
9 French catheter

9-13 French Repo Sheath

Fluid filled pressure lumen for placement monitoring
P1-9
Autoflow Control - Yes w/ AIC

Question 6

Impella 2.5 & CP Proper pump position?

Answer 6

~3.5cm below AV

Question 7

Impella 2.5 flow?

Answer 7

Mean flows 2.3-2.5

Question 8

Impella CP Mean flows?

Answer 8

3.3-3.5

CP has more windows vs. 2.5

Question 9

Pump size 2.5 & CP?

Answer 9

12F & 14F

Question 10

Introducer Size 2.5 & CP?

Type of Introducer 2.5 & CP?

Answer 10

2.5 = 13 Fr.

CP = 14 Fr.

Types
2.5 = Peel away
CP = Peel away w/ locking dilator

Question 11

Max RPM’s
2.5
CP
LD
5.0
RP

Answer 11

2.5 = 51,000
CP = 46,000
LD, 5.0, RP = 33,000

Question 12

Angle on elbow of cannula = ? Degrees?

Answer 12

145 degrees

Question 13

Purge pressure must always be above ?? mmHg

Answer 13

> 300 mmHg

Question 14

What dextrose solutions are ok?

Answer 14

D5-D40

Question 15

What is recommended purge fluid?

Answer 15

D5 with 50 units of heparin/mL

Question 16

Pressure sensor reads pressure from where?

And what is normal range of pressure?

Answer 16

Purge disc

Normal = 300-1100 mmHg

Question 17

AIC automatically adjust purge flow to maintain between ? - ? mL/hr

Answer 17

2-30 mL/hr

Question 18

AIC has 2 Main Functions

Answer 18

1. Power

2. Purge

Question 19

Internal battery on AIC can last up to ? Minutes

Answer 19

60 minutes

Question 20

Additional features on AIC

Answer 20

1. Power switch
2. Grounding stud
3. Ethernet port
4. Fuses
5. USB Port
6. Service
7. VGA Connection
8. Battery switch

Question 21

Double Hump (waveforms) = ?

Answer 21

Happy pump!

Question 22

Soft buttons down Right side of AIC ?

Answer 22

My (Mute alarm)
Friends (Flow control)
Don’t (Display)
Push (Purge system)
Me (Menu)

Question 23

Impella 2.5 RPM’s at P-8?

Impella CP RPM’s at P-8?

And at BOOST?

Answer 23

2.5 = 50,000
Boost = 1,000

CP = 44,000

Boost = 2,000