Intentional Delay of Mitral Valve Surgery due to Multiple Organ Failure and Interim Support with IMPELLA 5.0 : a Case Report

Abstract

A 49-year-old male was referred to our department for surgery because of uncontrollable congestive heart failure accompanied by severe liver dysfunction and acute renal failure. Echocardiography showed severe mitral regurgitation and reduced left ventricular ejection fraction (25%). Due to severe liver dysfunction, coagulopathy and reduced left ventricular function, intentional delay of surgery with interim IMPELLA 5.0 support was selected rather than an emergent surgery. The device was inserted through the right axillary artery to allow the patient to undergo a rehabilitation program before mitral valve surgery. After induction of the IMPELLA device, his multiple organ failure gradually improved. A mitral valve repair was successfully performed 14 days after the introduction of IMPELLA support. The postoperative course was uneventful except for minor complications. He was discharged 30 days after mitral valve surgery. IMPELLA 5.0 can offer effective support for the left ventricle and sufficient blood flow to damaged organs.