Impella 5.5 for AVR: Surgical Strategy, Weaning, & Patient Mobilization with Dr. Roland Hernandez and Dr. Chris Brown

How do surgeons decide when to place an Impella 5.5 before valve surgery?In this discussion, Dr. Roland Hernandez walks through his operative approach with Dr. Chris Brown, covering:Patient selection: when balloon pump isn’t enough supportStep-by-step technique for direct aortic Impella 5.5 insertionHow to tunnel and remove the graft safelyTechnical pearls for cross-clamp position and avoiding floodingStrategies for weaning from bypass to ImpellaCommon hazards: wire and catheter challenges for surgeonsWhy mobilization is critical and when Impella CP isn’t enoughThis case-based conversation offers a rare surgeon-to-interventionalist perspective on advanced mechanical circulatory support.🔔 Subscribe for more insights from interventional experts and real-world program builders.📱 Download the app: https://apps.apple.com/app/apple-store/id1586692687📺 Follow us on YouTube: https://www.youtube.com/channel/UCfrLYhAhliQ2ZvXinkDCZvAChapters:00:00 – Intro & guest background 00:45 – Patient case: severe LV dysfunction, AI + MR 02:10 – Why Impella 5.5 over balloon pump 03:20 – Preemptive strategy & surgical planning 03:40 – Direct aortic Impella 5.5 implantation technique 04:45 – Graft tunneling, closure, and removal details 06:20 – Operative sequence & bypass setup 08:10 – Positioning, cross-clamp, and cannulation pearls 09:00 – Valve replacement + Impella insertion steps 10:20 – Weaning from bypass to Impella support 12:00 – Technical challenges: wires & catheters 13:20 – Axillary vs supraclavicular approach considerations 14:30 – Hazards of clamp position & LV flooding 15:45 – Manipulating the device intra-op 16:10 – Deciding level of support: index, EF, gestalt 17:20 – Post-op outcomes, shock scenarios, and red flags 18:40 – Mobilization benefits: why 5.5 beats CP 20:00 – Closing thoughts & key lessons#Impella #MechanicalSupport #CardiacSurgery #AVR #InterventionalCardiology #TAVR #HeartFailure #MCS #Impella55 #MurmurMD