No Panic in Hemodynamics: A "Single-Access" Axillary Impella-Assisted Balloon Aortic Valvuloplasty in Cardiogenic Shock

Authors

Leo Kar Lok Lai, Henry Ford HealthFollow
Hussayn Alrayes, Henry Ford HealthFollow
Georgi Fram, Henry Ford HealthFollow
James Lee, Henry Ford HealthFollow
Brian O’Neill, Henry Ford HealthFollow
Tiberio M. Frisoli, Henry Ford HealthFollow
Pedro Engel Gonzalez, Henry Ford HealthFollow
William O'Neill, Henry Ford HealthFollow
Pedro Villablanca, Henry Ford HealthFollow

Recommended Citation

Lai LKL, Alrayes H, Fram G, Lee JC, O'Neill BP, Frisoli TM, Engel Gonzalez P, O'Neill WW, and Villablanca PA. No Panic in Hemodynamics: A "Single-Access" Axillary Impella-Assisted Balloon Aortic Valvuloplasty in Cardiogenic Shock. JACC Case Rep 2025;30(21):104411.

Document Type

Article

Publication Date

7-30-2025

Publication Title

JACC Case Rep

Abstract

A 68-year-old man with ischemic cardiomyopathy presented with critical aortic stenosis and Society for Cardiovascular Angiography and Interventions stage D cardiogenic shock. Because of occluded bilateral femoral vasculature, a right axillary single-access Impella balloon aortic valvuloplasty approach was successfully performed, improving the patient's cardiac index from 1.5 to 2.5 L/min/m(2). This case highlights the use of pre-intravascular ultrasound imaging, the "dry-exchange" technique to enhance safety, and single-access Impella balloon aortic valvuloplasty to maintain cardiac output during repeated prolonged balloon inflations.

PubMed ID

40750167

Volume

30

Issue

21

First Page

104411

Last Page

104411