A combined surgical and percutaneous approach through the axillary artery to introduce the Impella LP5.0 for short-term circulatory support.

We describe a novel axillary approach for insertion and usage of the Impella LP5.0, a low cost micro-axial flow pump, in five patients requiring circulatory support after acute ST-segment elevation myocardial infarction (STEMI). This alternative approach for implantation of the Impella LP5.0 has been proven simple, safe and feasible, and less invasive in severely compromised patients. Our hybrid, percutaneous and surgical, approach offered acute short-term circulatory support in STEMI patients with acute heart failure, allowing myocardial recovery or selection for long-term mechanical support.

Pulmonary arterial stent implantation in an adult with Williams syndrome.

We report a 38-year-old patient who presented with pulmonary hypertension and right ventricular dysfunction due to pulmonary artery stenoses as a manifestation of Williams syndrome, mimicking chronic thromboembolic pulmonary hypertension. The patient was treated with balloon angioplasty and stent implantation. Short-term follow-up showed a good clinical result with excellent patency of the stents but early restenosis of the segments in which only balloon angioplasty was performed. These stenoses were subsequently also treated successfully by stent implantation. Stent patency was observed 3 years after the first procedure.