Fracture of the cannula tip during removal of a long-term indwelling Impella 5.5: a case report.
We report a rare device fracture during Impella 5.5 explantation for cardiogenic shock in a 77-year-old man with prolonged device support. Following stabilization, device removal was attempted on day 50. During withdrawal, marked resistance was encountered and the cannula tip fractured, remaining within the prosthetic graft. The tip was surgically retrieved following extension of the dissection. Post-explantation, the patient developed acute right upper extremity ischemia, likely due to vasospasm, which resolved spontaneously. This case underscores the importance of recognizing marked resistance during Impella explantation, as excessive stress concentration and mechanical shearing forces may contribute to device fracture.