What does the Impella intra-aortic cardiac assist device do?

• A. Unloads blood from the right ventricle and sends it to the pulmonary artery
• B. Unloads blood from the left ventricle and shoots it into the aorta near the coronaries
• C. Increases left ventricular afterload
• D. Bypasses the heart entirely with an external circuit

Answer: (B)

Impella is a percutaneous left ventricular assist device that directly unloads the left ventricle by drawing blood from the LV and delivering it into the ascending aorta. By pulling blood from the LV, it lowers LV end-diastolic pressure and wall stress, which reduces myocardial oxygen demand and helps improve coronary perfusion and overall systemic perfusion. The outflow is into the aorta near the coronary arteries, aiding perfusion to the heart muscle while supported. It does not involve the right ventricle or pulmonary circulation, it does not increase LV afterload, and it does not bypass the heart with an external circuit.