Insertion of Impella 5.0 to improve candidacy for HeartMate II left ventricular assist device placement.

The Impella 5.0 is a minimally invasive heart assist device that can be used to stabilize patients with cardiogenic shock. We present the case of a 49-year-old female in cardiogenic shock who required left ventricular assist device placement, but was not an optimal candidate for surgery due to severe deconditioning and malnutrition. An Impella 5.0 pump was surgically implanted via right axillary artery approach, which allowed the patient time to improve nutritional and functional status before subsequent placement of HeartMate II left ventricular assist device.