Abiomed Impella LD Gebrauchsanweisung Seite 9

15. Press the FLOW CONTROL soft button to increase the P-level to P-9 to
confirm correct and stable placement. Verify placement with TEE and the
placement signal screen. Reposition the catheter as necessary.
Note: When the flow rate is increased to maximum flow, the Impella
LD Catheter has a tendency to be drawn into the ventricle. Check
positioning at maximum flow to ensure proper placement throughout
the P-level setting range
16. Position the front silicone plug as close as possible above the aorta.
Secure the silicone plug to the graft using a penetrating suture
ligature.
Note: When securing the silicone plug to the graft, ensure that the
penetrating suture does NOT go all the way through the silicone plug
and damage the Impella LD Catheter inside the plug.
Rear Silicone Plug
Ligature
Front Silicone Plug
Ligature
Penetrating
Suture
Penetrating
Suture
Transesophageal echocardiogram (TEE)
illustration showing correct Impella LD
®
Transesophageal echocardiogram (TEE)
illustration showing correct Impella LD
Impella LD ®
Catheter
inlet area
Impella LD ®
RV
Catheter
inlet area
RV
LV
LV
17. Clear the vascular graft of excess blood and resecure the rear silicone
plug to the end of the graft.
Impella LD ® Circulatory Support System
Rear Silicone Plug
Front Silicone Plug
Catheter position
Catheter position
®
Impella LD ®
Catheter
outlet area
Impella LD ®
Catheter
outlet area
Aortic valve
Aortic valve
LA
LA
18. After achieving correct and stable placement, decrease the P-level to the
desired level for support.
Note: After implantation of the catheter (and until explant), ACT should
be maintained at 160 to 180 seconds.
19. Select the lowest P-level that will enable you to achieve the flow rate
necessary for patient support. You can select one of ten P-levels (P-0 to
P-9) for the Impella LD Catheter
P-LEVELS
You can select one of ten P-levels (P-0 to P-9) for the Impella LD
Select the lowest P-level that will enable you to achieve the flow rate
necessary for patient support.
P-Level
P-0
P-1
P-2
P-3
P-4
P-5
P-6
P-7
P-8
P-9
*Flow rate can vary due to suction or incorrect positioning.
PURGE CASSETTE PROCEDURES
CHANGE CASSETTE & BAG
Follow these steps to change both the purge cassette and purge fluid:
1. Press PURGE MENU and select "Change Cassette and Bag" from the
menu.
2.
Select START to begin the cassette and fluid change process.
3.
When prompted by the controller, disconnect the luer from the Impella
catheter. Note on Connecting Purge Tubing to the Catheter: If
included, remove and discard the y-connector and connect the yellow
luer on the purge tubing directly to the yellow check valve on the
Impella Catheter.
4. Open the Purge Cassette door by pressing the button on the left side
of the console. Remove and discard the old cassette and purge fluid
bag.
5.
Open the new Purge Cassette. Spike the new purge fluid bag with the
new purge cassette tubing. Select NEXT to continue.
6.
Insert the new purge cassette into the controller. Be sure to slide the
purge disc into place and extend the purge tubing through the gap in
the purge cassette door when you close the door.
Catheter.
®
*Flow Rate (L/min)
0.0
0.0 – 1.4
0.5 – 2.6
0.5 – 3.1
0.9 – 3.4
1.4 – 3.7
1.8 – 4.0
2.6 – 4.4
3.4 – 4.7
4.2 – 5.3
7