Abstract
Ventricular septal defect (VSD) is a mechanical complication of myocardial infarction that can lead to rapid multiorgan system failure. Mechanical circulatory support is an invaluable tool to stabilize these patients before definitive surgical repair. The Impella 5.5 has been successfully used to maximize end-organ perfusion and as a bridge to delayed surgical repair. Preserving this device intraoperatively at the time of VSD repair is of great importance as mishandling can lead to device damage, thrombosis, and various postoperative complications. In this paper, we discuss tips on how to preserve this device during VSD repair.