CTICasesImpella Device Failure
Imaging findings
Serial chest radiographs show an Impella left ventricular assist device that was initially positioned correctly across the aortic valve. A subsequent radiograph shows the catheter has been retracted back into the ascending aorta. Review of the clinical history reveals the device had failed/stopped functioning, and was intentionally pulled back by the cardiologists to avoid impairing native aortic valve function prior to surgical replacement.
Key takeaways
An Impella is a catheter-mounted microaxial flow pump positioned across the aortic valve to support left ventricular output. Retraction of the device into the aorta is typically a sign of accidental dislodgement. However, in the setting of abrupt device failure, intentional retraction into the aorta is performed to prevent the non-functioning pump from obstructing the aortic valve orifice, highlighting the importance of clinical correlation before reporting malposition.
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