The Automated Impella Controller continuously monitors the catheter based on the placement signal and the motor current.
If the system alarms with one of the positioning alarms described in this section, fluoroscopic imaging is the best method for confirming position. You can also use TEE, TTE, or a standard chest x-ray.
If the Impella® Catheter is either partly (just the pigtail) or completely in the ventricle, reposition the catheter under imaging guidance.
If the Impella CP Catheter is in the correct position, the placement screen will appear as shown on the left.
If the Impella CP Catheter is fully in the ventricle, the following alarm will appear:
In this situation, the placement screen will appear.
If the Impella Catheter is completely in the aorta or if the inlet and outlet areas are in the ventricle and the open pressure area is in the aorta, the following alarm will appear:
In this situation, the placement screen will appear as shown.
When a patient has poor native ventricular function, the placement signal may remain pulsatile; however, the amplitude will be dampened. In a situation of low native heart pulsatility, the Automated Impella® Controller may not be able to determine the catheter position. You may see the following indication on the home screen:
In this situation, the screen will appear as shown.
If the Impella CP Catheter outlet area is on or near the aortic valve, the catheter may be too deep in the ventricle. The following alarm will appear: