CTICasesMalpositioned Impella Device
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Imaging findings
Chest radiograph demonstrates an Impella percutaneous left ventricular assist device positioned too proximal, with the catheter tip and inlet sitting at the level of the aortic valve rather than deep within the left ventricular chamber.
Key takeaways
The Impella device is a catheter-mounted microaxial flow pump designed to provide hemodynamic support. Accurate positioning is vital; the inlet must reside in the left ventricle and the outlet in the ascending aorta, crossing the aortic valve. Malposition can lead to pump dysfunction, hemolysis, or valve damage, necessitating immediate repositioning under fluoroscopic or echocardiographic guidance.
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