Which device unloads the left ventricle and delivers flow to the aorta near the coronary ostia?

Which device unloads the left ventricle and delivers flow to the aorta near the coronary ostia?

• A. IABP
• B. Impella
• C. LVAD
• D. External pump

Answer: (B)

The key idea is direct left ventricular unloading with immediate forward flow into the aorta just above the coronary arteries. The Impella is a percutaneous microaxial pump that sits across the aortic valve, drawing blood from the LV and pumping it into the ascending aorta. This arrangement unloads the LV rapidly and delivers flow right at the level of the coronary ostia, improving coronary perfusion. Intra-aortic balloon pump provides diastolic augmentation and modest afterload reduction but does not actively unload the LV or deliver large forward flow. LVADs offer substantial, continuous forward flow but are implanted differently (often from the LV apex) and do not deliver blood across the valve into the aorta immediately at the coronary ostia. External pumps lack the targeted cross-valve configuration.

The key idea is direct left ventricular unloading with immediate forward flow into the aorta just above the coronary arteries. The Impella is a percutaneous microaxial pump that sits across the aortic valve, drawing blood from the LV and pumping it into the ascending aorta. This arrangement unloads the LV rapidly and delivers flow right at the level of the coronary ostia, improving coronary perfusion.

Intra-aortic balloon pump provides diastolic augmentation and modest afterload reduction but does not actively unload the LV or deliver large forward flow. LVADs offer substantial, continuous forward flow but are implanted differently (often from the LV apex) and do not deliver blood across the valve into the aorta immediately at the coronary ostia. External pumps lack the targeted cross-valve configuration.