Percutaneous Ventricular Assist Devices: New Deus Ex Machina?

Figure 1

Schematic representation of two commercially available percutaneous ventricular assist devices (VAD). (a) The TandemHeart pVAD consists of a 21 F left atrial inflow cannula, an extracorporeal centrifugal pump rotating at up to 7500 rpm, a femoral outflow cannula (15 F–17 F) that extends into the iliac artery, and a microprocessor-based pump controller, which can provide blood flow up to 4 L/min. The tip of the atrial drainage cannula is positioned under fluoroscopic guidance into the left atrium following transseptal puncture. (b) The Impella LP 2.5 is a catheter-mounted device. The microaxial pump consists of an impeller driven by an integrated microelectric motor on the distal end of a flexible catheter. At a maximum speed of 33,000 rpm, the pump provides a maximum hydraulic capacity of 2.5 L/min. The Impella Recover LP 2.5 is retrogradely placed across the aortic valve into the left ventricle where it aspirates blood via a caged blood flow inlet which is then ejected into the ascending aorta.