Preemptive Direct Aortic Insertion of Impella 5.5 in Patients Undergoing Cardiac or Aortic Surgery

The mortality rate of postcardiotomy cardiogenic shock after cardiovascular surgery is quite high, and the only way to avoid this serious complication is to initiate a preemptive strategy during surgery. The Impella 5.5 device with the SmartAssist system (Abiomed) is mainly used to prevent or to treat cardiogenic shock in cardiac surgery, but it is not often used in aortic surgery. We present the technique of preemptive insertion of the Impella 5.5 device through the ascending aorta intraoperatively to prevent the onset of postcardiotomy cardiogenic shock after cardiac or aortic surgery.