What is an Impella heart pump?

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The Impella is a small ventricular assistance device. This means that it supports the functioning of the ventricles. These are the lower chambers of the heart that pump blood out of the heart and to the body.

It can help with heart failure and other heart conditions.

There are three key reasons why a person may need an Impella. They include:

• Heart failure: An enlarged and weak heart cannot effectively pump blood throughout the body, but the Impella can help improve blood flow. A doctor may recommend it to someone awaiting heart surgery or a heart transplant.
• Cardiogenic shock: A heart attack and some other emergencies can cause cardiogenic shock, which hinders the heart’s ability to pump blood. The Impella pumps blood through the ventricles, allowing the left ventricle to rest and improving the chances of recovering from cardiogenic shock.
• PCI: PCI procedures involve surgeons placing stents or balloons to treat blocked arteries. They can save lives, but they can also pose risks for people with heart health issues. The Impella can help sustain blood flow through the organ during these procedures.

Unlike some other heart pumps, the Impella does not require heart surgery for insertion.

Instead, the doctor makes a small incision in the leg to access the femoral artery. They then thread the pump into the left ventricle via the femoral artery.

The heart consists of four chambers.

The top two chambers are the atria, which pump blood to the lower two chambers, called the ventricles. The ventricles then pump blood throughout the body.

The Impella replaces the function of the left ventricle, pumping blood out of the heart and to the rest of the body. This serves several functions, including:

• allowing the left ventricle to rest and recover following cardiogenic shock
• ensuring adequate blood flow when the heart is not working well
• helping protect the heart and the organs during certain medical procedures, especially PCIs

Additionally, the Impella sends information to an external console. It tells healthcare professionals about how well the heart is working and how much blood the Impella is pumping.

It is important to note that the Impella is only suitable for use in hospital settings. This means that it is a short-term solution for most people, usually as they recover from a cardiovascular event or await a longer-term treatment, such as a heart transplant or open heart surgery.

Impella heart pumps are expensive, but medical insurance often fully or partially covers this treatment.

A 2019 study found that, after the introduction of Impella pumps, the cost of treating people with mechanical devices rose from $47,000 to $51,000 per person. The actual cost an individual pays depends on their insurance, the hospital they are at, and any other care they need.

Some people may pay nothing or a small copay, while others may pay close to the full cost of the device. If a person is unsure about whether or not a medical device is eligible for coverage, they should contact their insurance provider.

Generally, people who need an Impella have serious health complications such as heart failure.

These complications can make inserting the device difficult and may also increase the dangers of infections and other side effects. Therefore, it is important to discuss the risks and benefits of the procedure with a doctor.

Some potential risks include:

• bleeding that may become life threatening
• damage to the blood vessels
• damage to the heart
• liver failure
• kidney failure
• dangerously low blood pressure
• infection, including life threatening sepsis
• death
• heart attack
• dangerous heart arrhythmias, or an irregular heartbeat

The Impella is not the only heart pump available. There may be safer alternatives depending on a person’s needs and medical condition, so it is important to ask a doctor for guidance about the best option.

It is possible for a doctor to insert the Impella while a person is awake. This may be ideal for people who cannot safely go under anesthesia or those who prefer to be awake.

If a person is awake during the procedure, a doctor will usually give them pain medication and drugs to help them feel groggy and relaxed.

Some people can have general anesthesia, meaning they will be asleep and have no memory of the procedure.

To insert the Impella, a doctor makes a small cut in the upper thigh, near the groin. They then thread the device up to the heart through a long thin catheter. Once the device is in the heart, a doctor removes the catheter.

LVADs are devices that help the ventricles pump blood to the rest of the body.

The Impella is a type of LVAD, but many other types of these devices are available. Some, such as the Impella, provide short-term support, while others offer longer-term aid.

Some other LVADs include:

• Heartware
• Heartmate 3
• SynCardia Total Artificial Heart

Several observational studies suggest that the Impella may reduce the risk of death following cardiogenic shock, but randomized controlled trials have not proven this claim.

Overall, a person’s prognosis depends on the reason they need the Impella and other treatment options that become available. For example, someone who needs and eventually gets a heart transplant may have a better outcome than an individual who continues to wait for a transplant.

When the Impella enables a person to wait longer for a necessary procedure, it can improve outcomes.

However, there is no specific data showing the Impella’s overall role in cardiovascular health or heart failure outcomes. People can ask a doctor about risks, benefits, and the outlook for their specific condition.

The Impella can help the heart rest and maintain health as they await surgery or a heart transplant. For some people, it is a life changing or life-saving treatment.

However, like any medical procedure, it poses some risks. It is important to speak with a doctor about the risks and benefits of the pump, treatment goals, alternative options, and the long-term prognosis.