3．Impella挿入法

Impella Implantation Technique for Surgeons

薬物療法抵抗性の心原性ショックに対するImpella 2.5，5.0の使用が保険適用となり1年半が経過し，国内90施設で800例に用いられている．本稿では合併症を起こさず，十分にデバイスが機能するようなImpellaの植込み方法について解説する．

Impella, a newly developed microaxial blood pump, has been used as a less invasive left ventricular assist device in more than 800 case in the last 18 months since its approval in Japan. Our experiences in 26 patients indicated that it improved not only cardiac output, but also cardiac function, which resulted in cardiac recovery in 16 patients. In this article technical knack and pitfalls including vascular approach and catheter manipulation during implantation, exchange, and explantation of Impella were described. Cardiovascular surgeons who know the detail of the techniques may play a crucial role in successful less invasive mechanical circulatory support for cardiogenic shock patients.