A new generation of Impella (Abiomed, USA) has just arrived on the market: the Smart Assist (SA) model, more functional and adapted to the new technological era in which we live. The sensor type and position have been changed: it now has an optical sensor in the blood outflow cannula, which allows more precise confirmation of the position of the device and reduces the risk of hemolysis. It also provides better hemodynamic support, with peak flows of 4.3 L/min (mean flow, 3.8-3.9 L/min) for the Impella SA (up to 46 000 rpm support, with no time limit). All this hemodynamic information is available on the controller display screen, which shows the left ventricular pressure, the total cardiac output (Impella flow + native cardiac output) and the CPO (cardiac power output).
The aspiration and position alarms are displayed more quickly and precisely, as is their resolution. The pump can be positioned without imaging using the controller.
Furthermore, the screen displays trends that help guide the patient management during support and weaning, simplifying decision-making.
The set-up is faster, as it has fewer connections (it has a lead that is already set-up, and the red pressure sensor light has been removed).
The introducer kit contains, in addition to the 14 Fr x 13 cm introducer, another 14 Fr x 25 cm introducer with longer, tapered dilators.
Soon, the platform for remote access to the controller using artificial intelligence, called Impella Connect, will be available—a great technological advance.
Keywords: High-risk PCI, Impella SA, cardiogenic shock, heart assist devices, hemodynamics, mechanical support devices.