Abstract
Introduction: Off-pump coronary artery bypass grafting (OPCABG) may be
performed on patients with high surgical risk who are poor candidates
for traditional mechanical circulatory support. Hemodynamic support with
micro-axial mechanical circulatory devices has been performed with
limited but promising results. Case Presentation: We report a case of
66-year-old male with multiple comorbidities and low cardiac output
undergoing OPCABG. Impella CP device was deployed for “in-pump”
support during surgical coronary revascularization resulting in
intraoperative stability and uncomplicated post-operative recovery.
Discussion: Previous reports have described use of the Impella Recover
LP 5.0 device for use during OPCABG. We describe the successful and safe
perioperative use of the Impella CP device. Despite lower flow rates,
adequate support was achieved and the transfemoral cannulation and
smaller outer diameter than the Impella 5.0 device may decrease the risk
of complications and expedite recovery. Conclusion: Further research
will be necessary to determine the optimal perioperative hemodynamic
support strategy to offer hemodynamically unstable, high and prohibitive
risk patients.