Caso clínico: canalización axilar en asistencia ventricular Impella CP®

Abstract

The Impella CP® catheter is a temporary left ventricular assist device that pumps blood from the left ventricle to the ascending aorta, and can provide up to 4.1 L/min of flow, depending on the power and volume. We present the case of a 65-year-old male who was admitted to the coronary intensive care unit with low cardiac output. An intra-aortic balloon pump for counterpulsation was placed (for a period of 28 days) and the patient was listed for urgent heart transplantation [urgency status 1 according to the classification of the Spanish National Organization for Transplantation (ONT)]. On day 29 after admission, an Impella CP® was placed via the axillary artery, and the urgency status becomes 0 (Spanish ONT classification). The patient underwent heart transplant on day 21 after placement of Impella CP®. The patient was discharged 6 days later, after 56 days in hospital. During continuous nursing assessment, according to Virginia Henderson‘s needs pattern, the following diagnoses were observed: acute pain, activity intolerance and willingness to improve self-concept. Compared to femoral access, the axillary canalization of the Impella© CP ventricular assist device opens a new era in nursing care for patients requiring this device. The improvement in activity tolerance and a better understanding of their health status results in improved patient status while they await heart transplantation, thus reducing complications and hospitalization time post transplant.