Right ventricular failure secondary to pulmonary embolism is associated with morbidity and death. The Impella RP System has often been used for percutaneous mechanical circulatory support in patients with right ventricular failure from other causes, including myocardial infarction, cardiac surgery, and left ventricular assist device implantation. We report 2 cases of massive pulmonary embolism in which combined Impella RP use and ultrasound-assisted catheter-directed thrombolysis effectively treated shock caused by right ventricular failure and contributed to successful outcomes. To our knowledge, only one other patient with this indication had been treated with the Impella RP device.
Keywords: Catheterization, peripheral/instrumentation; combined modality therapy; equipment design; heart-assist devices; pulmonary embolism/complications/therapy; recovery of function; thrombolytic therapy; treatment outcome; ultrasonic therapy/instrumentation; ventricular dysfunction, right/physiopathology/therapy.