Abstract
The Impella device is a percutaneous left ventricular assist device (LVAD) designed to increase systemic blood flow and reduce the left ventricular mechanical workload in a support flow-dependent manner. It is used for the treatment of acute heart failure and cardiogenic shock resulting from myocardial infarction (MI), fulminant myocarditis, acute-on-chronic heart failure, and end-stage heart failure in patients on the LVAD or heart transplant waiting list. The advantages of employing the Impella device in such clinical situations are evident, leading to its global approval, including in Japan. In the United States, Impella has gained approval as a supportive device for high-risk percutaneous coronary intervention and is currently undergoing a post-marketing clinical trial. Recently, it was demonstrated to be effective in other high-risk catheter interventions, such as catheter ablation for arrhythmia and catheter interventions for structural heart disease. In surgical procedures, its use in the perioperative period for bypass surgery, valvular diseases, and ventricular septal rupture after MI has been shown to enhance the surgical outcomes. In this review, we introduce the utility of the Impella device in optimizing heart failure interventions, considering its cardiac and hemodynamic mechanisms of action.
