Severe hemolysis associated with use of the impella LP 2.5 mechanical assist device

The Impella LP 2.5 is a percutaneously implantable axial flow device designed to offer circulatory support for patients in cardiogenic shock during percutaneous coronary interventions (PCI). While most axial flow devices are associated with hemolysis, clinically relevant hemolysis with this device has not been reported. We report a case of a 66-year-old woman with hemodynamic collapse during an elective PCI who was successfully resuscitated with an Impella device. She developed marked biochemical evidence of intravascular hemolysis. This necessitated device removal which resulted in prompt resolution of the hemolysis. We advise routine measurement of biochemical markers of hemolysis and serial hemoglobin values during Impella device support to allow timely detection and treatment of this important complication.