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Figure 2 | Critical Care

Figure 2

From: Doubling survival and improving clinical outcomes using a left ventricular assist device instead of chest compressions for resuscitation after prolonged cardiac arrest: a large animal study

Figure 2

Intravascular cardiopulmonary resuscitation device placement using fluoroscopy. Intraventricular placement of the intravascular cardiopulmonary resuscitation (iCPR) device (modified Impella 2.5; Abiomed Europe GmbH, Aachen, Germany) before cardiac arrest and CPR as depicted by fluoroscopy (Ziehm Vision; Ziehm Imaging GmbH, Nuremberg, Germany). (A) A pigtail catheter is advanced into the descending (thoracic) aorta. SG, Swan-Ganz catheter; PT, Pigtail catheter. (B) The guidewire is advanced into the left ventricle via the pigtail catheter in situ. (C) Final position of the guidewire (GW) following removal of the pigtail catheter. (D) The iCPR device is advanced into the ascending aorta using the guidewire. (E) The iCPR device passes through the aortic arch. (F) Final position of the iCPR device with the tip situated in the left ventricle following the removal of the guidewire. I, Inlet; O, Outlet; AO, Approximate location of the aortic valve. Besides the materials mentioned and depicted above, a 13-French sheath introducer (Impella 2.5 introducer kit 13 F, 13 cm; Abiomed, Danvers, MA, USA) and an external microcontroller (Impella Controller; Abiomed) are required for placement and operation of the iCPR device.

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Critical Care

ISSN: 1364-8535