[Microaxial Flow Pump( Impella):Clinical Evidence and Guideline].

The Impella is a catheter-based microaxial flow pump that is inserted through a small vascular graft (Impella 5.5) or directly from femoral artery (Impella CP) and placed across the aortic valve. By draining blood from the left ventricle and pumping it to the ascending aorta, the device not only increases cardiac output, but also unloads the left ventricle which facilitates recovery of damaged cardiac muscles. It has been used in more than 14,000 cardiogenic shock patients in Japan and excellent clinical outcomes have been published in more than 20 major journals in the last three years using J-PVAD registry which is a mandatory national database. New evidences and guidelines may upgrade the value of this device as a less invasive left ventricular unloading device even more in the near future.