Knowing Your Device and
Understanding Surgery
Over the years, advanced technology has been used to develop devices to help patients diagnosed with heart failure. Many of these devices, although designed for adults, have been adapted for use in children. Let’s explore each device and what to expect before, during, and after surgery.
Over the years, advanced technology has been used to develop devices to help patients diagnosed
with heart failure. Many of these devices, although designed for adults, have been adapted for use
in children. Let’s explore each device and what to expect before, during, and after surgery.
1
Pacemaker/ICD
2
VADs
3
Pre-Transplant
4
CardioMEMS™
Impella®
Overview
Your Impella® heart pump works by continuously moving blood from the weak part of your heart, through the device, out to the aorta, and then to the rest of your body. A tiny motor inside the catheter spins to keep blood flowing, so your heart gets a chance to rest and recover.
The pump is always connected to an external controller called the Automated Impella Controller (AIC). The AIC powers the pump, regulates its speed, and displays important information about how the pump is working.
How does it work?
The Impella® is placed directly in your heart through a blood vessel — most often in your leg or arm. A thin, flexible tube called a catheter connects the pump (inside your heart) to the AIC console (outside your body). The pump draws blood in through one end and pushes it out through the other end into the aorta, bypassing the weak part of your heart.
Where is the Impella® implanted?
The pump can be placed in the left or right side of your heart, depending on which side needs support. Your care team will check the box that applies to you.
Already have an Impella®?
Want more information? Check out the Impella® Patient Education Handbook
Device Components
The equipment is life-saving and managing it may feel overwhelming. Learning how each piece works together will help you feel more comfortable in your daily journey.
1 Heart Pump
There are different Impella® pump models depending on what kind of support you need.
All Impella® devices include a sensor called SmartAssist that helps confirm the catheter is positioned correctly in the heart.
2 Catheter
The catheter is a long, flexible cord that connects the heart pump (inside your body) to the AIC controller (outside your body). It has two important jobs:
- It delivers power to the pump to keep it spinning.
- It sends information back to the controller about how the pump is working.
It is very important that the catheter is anchored to your skin correctly to prevent movement. The insertion site must stay clean and covered to prevent infection.
3 Automated Impella® Controller (AIC)
The AIC is a computer on a wheeled cart that powers and monitors your heart pump. When fully charged, the battery lasts 60 minutes or more.
Alarms
The AIC shows three types of alarms. Your care team will monitor and respond to them. Let them know right away if an alarm keeps sounding without being addressed.
- CRITICAL (Red)
Means there is a serious problem with the device that needs urgent attention. May require an echocardiogram, X-ray, or blood work. Examples: battery failure, device disconnect, flow or purge errors. - SERIOUS (Yellow)
Signals that something is not normal and needs follow-up. Examples: battery or temperature issues, signal errors. - ADVISORY (White)
Less urgent — often acts as a reminder or alert for minor issues, like running on battery or changes in purge flow.
4 Purge Cassette
A special fluid flows constantly through the purge cassette system. It moves slowly from the cassette, through the catheter, to the heart pump — stopping blood from entering the motor. Your care team will change the cassette as needed.
Mathematics & Mechanics
There are important numbers on the AIC display that your care team will monitor. Understanding what they mean can help you feel more informed about how your pump is working.
P-Level (Flow Control)
Tells the pump how fast to spin. A higher P-level means more blood delivered to the body.
Impella Flow (L/min)
Shows how much blood is being pumped through the device each minute. A spinning icon indicates the device is running.
Motor Current (mA)
Shows how much energy the pump is using. Helps the team confirm the device is positioned correctly.
Aortic / Left Placement Signal (mmHg)
Pressure waveforms used with left heart support to confirm the device is in the correct position.
Pulmonary Artery Signal (mmHg)
Pressure waveform used with right heart support to confirm correct position.
Purge Flow (mL/hour)
Amount of fluid flowing through the catheter to prevent blood from entering the motor.
Purge Pressure (mmHg)
Amount of pressure needed to push the purge fluid through the pump.
Benefits
The Impella® heart pump is used as a temporary support device. Depending on your situation, it may be used as:
- Bridge to Transplant: To support the heart and keep the body strong while waiting for a donor heart to become available.
- Bridge to a Longer-Term Device: To stabilize the heart until a different type of pump — like an LVAD — can be implanted for longer-term support.
- Support During a Procedure: To provide extra blood flow to the body while another heart procedure is being performed.
- Bridge to Recovery: To give the heart a chance to rest and recover, with the goal of eventually removing the pump.
- Bridge to Decision: To support the heart and improve blood flow while the care team determines the best next step, even if the future path is not yet known.
Risks
There are some risks with the Impella®, but your care team will work hard to keep you safe. Learning about potential complications helps you know what to watch for and when to contact your care team.
Infections
The insertion site must stay clean and covered. Your care team will do frequent sterile dressing changes. Signs of infection include redness, pain, drainage, swelling, warmth, or fever. If infection spreads to the blood, it is called sepsis or bacteremia and will require IV antibiotics.
Strokes
Blood clots or bleeding in the brain can cause a stroke. Notify your care team right away if you notice: unusual headaches, numbness or tingling on one side, weakness on one side, slurred speech, uneven facial movements, or pupil size differences.
Bleeding
Blood thinners increase your risk of bleeding. Nose bleeds are common — hold pressure at the bridge of your nose for 10 minutes. Serious belly bleeds (GI bleeds) are rare but may show as black stools, vomiting blood, or belly pain. Tell your care team immediately.
Hemolysis
When red blood cells break down inside the pump — this is called hemolysis. Your care team monitors your urine color and lab results. Signs include pink, red, or tea-colored urine. Settings or medicines may be adjusted if this occurs.
Pump Clots
A clot inside the pump can affect how well it works. If adjusting blood thinner medicine does not help, the pump may need to be replaced.
Right Heart Failure
The right side of the heart must pump blood to the left side for the Impella® to work properly. If it does not, you may need IV medicines or even a second pump to support the right side.
Limb Ischemia
An Impella® in an artery can sometimes reduce blood flow to the arm or leg where the catheter was placed. Symptoms include numbness, tingling, pain, or discoloration in the hand or foot. Tell your care team right away if you notice any of these signs.
Device Components
The equipment is life-saving and managing it may feel overwhelming. Learning how each piece works together will help you feel more comfortable in your daily journey.
1 Heart Pump
There are different Impella® pump models depending on what kind of support you need.
All Impella® devices include a sensor called SmartAssist that helps confirm the catheter is positioned correctly in the heart.
2 Catheter
The catheter is a long, flexible cord that connects the heart pump (inside your body) to the AIC controller (outside your body). It has two important jobs:
- It delivers power to the pump to keep it spinning.
- It sends information back to the controller about how the pump is working.
It is very important that the catheter is anchored to your skin correctly to prevent movement. The insertion site must stay clean and covered to prevent infection.
3 Automated Impella® Controller (AIC)
The AIC is a computer on a wheeled cart that powers and monitors your heart pump. When fully charged, the battery lasts 60 minutes or more.
Alarms
The AIC shows three types of alarms. Your care team will monitor and respond to them. Let them know right away if an alarm keeps sounding without being addressed.
- CRITICAL (Red)
Means there is a serious problem with the device that needs urgent attention. May require an echocardiogram, X-ray, or blood work. Examples: battery failure, device disconnect, flow or purge errors. - SERIOUS (Yellow)
Signals that something is not normal and needs follow-up. Examples: battery or temperature issues, signal errors. - ADVISORY (White)
Less urgent — often acts as a reminder or alert for minor issues, like running on battery or changes in purge flow.
4 Purge Cassette
A special fluid flows constantly through the purge cassette system. It moves slowly from the cassette, through the catheter, to the heart pump — stopping blood from entering the motor. Your care team will change the cassette as needed.
Mathematics & Mechanics
There are important numbers on the AIC display that your care team will monitor. Understanding what they mean can help you feel more informed about how your pump is working.
P-Level (Flow Control)
Tells the pump how fast to spin. A higher P-level means more blood delivered to the body.
Impella Flow (L/min)
Shows how much blood is being pumped through the device each minute. A spinning icon indicates the device is running.
Motor Current (mA)
Shows how much energy the pump is using. Helps the team confirm the device is positioned correctly.
Aortic / Left Placement Signal (mmHg)
Pressure waveforms used with left heart support to confirm the device is in the correct position.
Pulmonary Artery Signal (mmHg)
Pressure waveform used with right heart support to confirm correct position.
Purge Flow (mL/hour)
Amount of fluid flowing through the catheter to prevent blood from entering the motor.
Purge Pressure (mmHg)
Amount of pressure needed to push the purge fluid through the pump.
Benefits
The Impella® heart pump is used as a temporary support device. Depending on your situation, it may be used as:
- Bridge to Transplant: To support the heart and keep the body strong while waiting for a donor heart to become available.
- Bridge to a Longer-Term Device: To stabilize the heart until a different type of pump — like an LVAD — can be implanted for longer-term support.
- Support During a Procedure: To provide extra blood flow to the body while another heart procedure is being performed.
- Bridge to Recovery: To give the heart a chance to rest and recover, with the goal of eventually removing the pump.
- Bridge to Decision: To support the heart and improve blood flow while the care team determines the best next step, even if the future path is not yet known.
Risks
There are some risks with the Impella®, but your care team will work hard to keep you safe. Learning about potential complications helps you know what to watch for and when to contact your care team.
Infections
The insertion site must stay clean and covered. Your care team will do frequent sterile dressing changes. Signs of infection include redness, pain, drainage, swelling, warmth, or fever. If infection spreads to the blood, it is called sepsis or bacteremia and will require IV antibiotics.
Strokes
Blood clots or bleeding in the brain can cause a stroke. Notify your care team right away if you notice: unusual headaches, numbness or tingling on one side, weakness on one side, slurred speech, uneven facial movements, or pupil size differences.
Bleeding
Blood thinners increase your risk of bleeding. Nose bleeds are common — hold pressure at the bridge of your nose for 10 minutes. Serious belly bleeds (GI bleeds) are rare but may show as black stools, vomiting blood, or belly pain. Tell your care team immediately.
Hemolysis
When red blood cells break down inside the pump — this is called hemolysis. Your care team monitors your urine color and lab results. Signs include pink, red, or tea-colored urine. Settings or medicines may be adjusted if this occurs.
Pump Clots
A clot inside the pump can affect how well it works. If adjusting blood thinner medicine does not help, the pump may need to be replaced.
Right Heart Failure
The right side of the heart must pump blood to the left side for the Impella® to work properly. If it does not, you may need IV medicines or even a second pump to support the right side.
Limb Ischemia
An Impella® in an artery can sometimes reduce blood flow to the arm or leg where the catheter was placed. Symptoms include numbness, tingling, pain, or discoloration in the hand or foot. Tell your care team right away if you notice any of these signs.
