If your patient suffers from the following conditions, even if they are too high risk for surgery, they may be a candidate for an Impella heart-pump-supported procedure. Your therapy awareness manager (TAM) can help you further identify patients who may benefit from the procedure.
Does your patient show signs of severe coronary artery disease?
- Multi-vessel disease 1,2
- PCI of last available conduit 2
- Unprotected or distal left main disease1
Does your patient have procedure-based risks?
- Anticipated prolonged ischemic time
- Atherectomy planned3
- Retrograde CTO planned4
- Anticipated use of guide extensions
- Large area of myocardium at risk5
- Unavailability of immediate surgical support
Does your patient show hemodynamic risks?
- Mild, moderate, or severely depressed ejection fraction (EF)2
- Borderline hemodynamic parameters
Does your patient have comorbidities?
- Advanced age1
- Frailty
- Renal insufficency1
- Acutely decompensated heart failure 1,5
- Diabetes1
- ACS (unstable angina/NSTEMI)1,5
- Aortic stenosis
- Moderate/severe mitral regurgitation
Does your patient have surgical risks?
- Surgical turndown (physician or patient preference)6
- High risk for surgery (STS>4 or Syntax>22)8
- Prior CABG1
- Cerebrovascular disease8
Does your patient have contraindications?
- Mechanical aortic valve
- Known LV thrombus
- Iliofemoral artery occlusion (if alternative access skill set not available)
- Aortic stenosis (area ≥ 0.6xm2)
If your patient has any of the conditions above, contact your local therapy awareness manager.
References
- Dangas, G.D., et al. (2014). Am J Cardiol, 113(2), 222-228.
- Maini, B., (2014). Catheter Cardiovasc Interv, 83(6), E183-E192.
- Gregory, D., (2013). J Manag Care Med, 16(1), 61-69.
- Gregory, D., (2013). Am Health Drug Benefits, 6(2), 88-99.
- O'Neill, W.W., et al. (2012). Circulation, 126(14), 1717-1727.
- O'Neill, W.W., et al. (2014). J Interviev Cardiol, 27(1), 1-11.
- Roos, J.B., et al. (2013). J Med Econ, 16(3), 3381-3390.
- PROTECT II Data on File
NPS-4263