A Case of Intracerebral Hemorrhage during IMPELLA Support and Craniotomy for Hematoma Removal

DOI Web Site Web Site 13 References
  • Kobai Kaori
    Department of Emergency and Critical Care Medicine, Nippon Medical School Department of Anesthesiology, Wakayama Medical University
  • Nakae Ryuta
    Department of Emergency and Critical Care Medicine, Nippon Medical School
  • Nakata Jun
    Division of Cardiovascular Intensive Care, Nippon Medical School Hospital
  • Igarashi Yutaka
    Department of Emergency and Critical Care Medicine, Nippon Medical School
  • Masuno Tomohiko
    Department of Emergency and Critical Care Medicine, Nippon Medical School
  • Yamamoto Takeshi
    Division of Cardiovascular Intensive Care, Nippon Medical School Hospital
  • Yokobori Shoji
    Department of Emergency and Critical Care Medicine, Nippon Medical School

Bibliographic Information

Other Title
  • IMPELLA補助管理中に脳内出血をきたし開頭血腫除去術を施行した1例
  • IMPELLA ホジョ カンリ チュウ ニ ノウナイ シュッケツ オ キタシカイトウ ケッシュ ジョキョジュツ オ シコウ シタ 1レイ

Search this article

Abstract

<p>IMPELLA® (Abiomed) is a catheter-type left ventricular assist device (LVAD) with a built-in micro axial flow pump that removes blood from the left ventricle and delivers it to the ascending aorta. Use of this device for severe heart failure has recently increased. Here, we report a case of intracerebral hemorrhage occurring during the introduction of IMPELLA support which was successfully treated by craniotomy. The patient was a 23-year-old man who was admitted to another hospital with the diagnosis of low cardiac output syndrome associated with dilated cardiomyopathy. He was treated with respiratory management, including noninvasive positive pressure ventilation, and circulatory management with inotropic drugs and an intra-aortic balloon pump. His respiratory and circulatory condition worsened, however, and he was transferred to our hospital for advanced heart failure treatment. After admission, an IMPELLA CP was inserted via the right femoral artery and his hemodynamics were stabilized. However, weaning from the IMPELLA CP failed due to a lack of cardiac recovery, and ventricular support was escalated from the IMPELLA CP to IMPELLA 5.0 via the right subclavian artery. On the 36th day after admission, the patient suddenly developed intracerebral hemorrhage in the temporal and parietal lobes with midline shift, and craniotomy was performed under IMPELLA support. The postoperative course was good and he was able to walk with assistance. He was transferred to a rehabilitation hospital on the 105th day of hospitalization. Few reports of IMPELLA-related hemorrhagic stroke have appeared, and the incidence is not precisely known. To our knowledge, craniotomy under IMPELLA support has not been previously reported, and the accumulation of additional cases is required.</p>

Journal

References(13)*help

See more

Keywords

Details 詳細情報について

Report a problem

Back to top