Impella

Impella is a family of medical devices used for temporary ventricular support in patients with depressed heart function. Some versions of the device can provide left heart support during other forms of mechanical circulatory support including ECMO and Centrimag.[1]

The device is approved for use in high-risk percutaneous coronary intervention (PCI) and cardiogenic shock following heart attack or open heart surgery and is placed through a peripheral artery.[2] From the peripheral artery it pumps blood to the left or right heart via the ascending aorta or pulmonary artery.

The Impella technology was acquired by Abiomed in 2005.[3] As of March 2019, the Impella series includes: the Impella 2.5, Impella 5.0/LD, Impella CP and Impella RP.[4][5][6]

Medical uses

The Impella device is an alternative for percutaneous mechanical circulatory support that has been utilized as a bridge to recovery. Used alone or in tandem sets, it utilizes the concept of magnetic levitation[clarification needed] to reduce moving parts to an absolute minimum, thus reducing anticoagulation requirements. Cardiogenic shock has been addressed by many devices, most notably the intraaortic balloon pump (IABP). The technology deployed by the Impella device similarly alters the fundamental characteristics of the human circulatory system. As the propeller is accelerated to give respite to an acutely injured myocardium, the circulatory system transitions from a pulsatile mechanism to continuous flow. Cellular response to cardiogenic shock is poorly described by either method (counterpulsation or continuous flow). Control of directional flow of the device (magnetic vectors) is under investigation for addressing right- versus left-sided heart failure. Transseptal intervention in addressing physiologic mismatch in perfusion between left- and right-sided heart failure is in experimental status.[citation needed] However, recent studies point to significantly greater in-hospital risks of major bleeding, death, and other adverse events for patients supported by Impella devices, compared with those managed with an IABP.[7] A propensity-matched comparison of patients receiving mechanical circulatory support (MCS) for myocardial infarction–related shock saw a nearly one-third excess in mortality and almost a doubling in risk of major bleeding, both in-hospital endpoints, with use of Impella compared to IABP. Impella may provide some of the results similar to venoarterial extracorporeal life support and TandemHeart.[8]

In patients with acute myocardial infarction complicated by cardiogenic shock, haemodynamic support with the Impella device had no significant effect on thirty-day mortality as compared with IABP.[9] Overall outcomes in the population, regardless of MCS device, were significantly worse for patients after the 2008 approval of Impella.[clarification needed] Among hospitals using Impella, those using it the most had significantly worse outcomes with Impella than those using it the least.[citation needed]

Potential complications related to the use of Impella are device related,[clarification needed] peripheral vascular and distal thrombus formation with subsequent strokes. The most common complications reported were bleeding requiring transfusion, vascular access complications, infection, haemolysis, vascular complications requiring surgical repair, limb ischaemia, and bleeding requiring surgical intervention (2.6%). Valvular complications included aortic and mitral valve injury or mitral valve regurgitation.[10]

Technology

Impella heart pumps are percutaneous microaxial pumps that act as mechanical circulatory support devices in patients in need of hemodynamic support.[11] The pumps are mounted on support catheters and typically inserted through the femoral artery, although axillary and subclavian artery approaches are not uncommon.[12]

The Impella Device is a generational extension of the Intra aortic balloon pump (IABP) in addressing cardiogenic shock. Tech has allowed a single moving piece floated by magnetically steered mechanisms to deploy an "Archimedes Pump" just north of the Aortic Valve that purports to reduce both preload and afterload. The same tech can apparently also be deployed just above the pulmonary (pulmonic) valve as a gate on right sided heart failure.

Left-sided support

Designed to provide hemodynamic support when the patient's heart is unable to produce sufficient cardiac output, Impella heart pumps can supply one to five liters per minute of blood flow.[13] The physiological consequences of left-sided support are threefold. First, it unloads the left ventricle by reducing left ventricular end-diastolic volume and pressure, thereby decreasing ventricular wall stress, work, and myocardial oxygen demand.[14][15][16][17] Second, it increases mean arterial pressure, diastolic pressure, and cardiac output, improving cardiac power output and cardiac index.[15] The combined effects on wall stress and perfusion pressure (especially diastolic pressure) augment coronary perfusion.[14][18] Lastly, augmented cardiac output and forward flow from the left ventricle decreases pulmonary capillary wedge pressure and reduces right ventricular afterload.[19][20][21]

Approval

Impella was approved for mechanical circulatory support in 2008, but large-scale, real-world data on its use are lacking. In June 2008, the Impella 2.5 heart pump received FDA 510(k) clearance[22] for partial circulatory support for periods of up to six hours during cardiac procedures not requiring cardiopulmonary bypass. In March 2015, it received FDA premarket approval for elective and urgent high-risk percutaneous intervention procedures.[23] In December 2016, the premarket approval was expanded to include the Impella CP heart pump.[24]

In April 2009, the Impella 5.0 and Impella LD heart pumps received 510(k) clearance for circulatory support for periods of up to six hours during cardiac procedures not requiring cardiopulmonary bypass.[25] In July 2010, the automated Impella controller received FDA 510(k) clearance for use by trained healthcare professionals in healthcare facilities and medical transport.[26]

In January 2015, the Impella RP was granted a humanitarian device exemption to provide circulatory assistance for patients with right heart failure.[27]

In February 2018, the FDA approved the sale of the Impella ventricular support systems.[5]

Deaths and strokes in the data base overall increased after the Impella gained regulatory approval in 2008, compared to earlier years; mortality went up 17% and strokes more than tripled.[28]

In July 2023, the FDA issued a Class I recall for all Impella left-sided blood pumps due to risk of motor damage after contact with a transcatheter aortic valve replacement stent.[29][30]

In March 2024, the FDA issued a warning about Impella left-sided blood pumps being linked to 49 deaths due to left ventricular perforation or wall rupture.[31][32]

See also

References

  1. ^ Shishehbor, MH; Moazami, N; Tong, MZ; Unai, S; Tang, WH; Soltesz, EG (April 2017). "Cardiogenic shock: From ECMO to Impella and beyond". Cleveland Clinic Journal of Medicine. 84 (4): 287–295. doi:10.3949/ccjm.84gr.17002. PMID 28388392.
  2. ^ Bansal, A; Bhama, JK; Patel, R; et al. (2016). "Using the minimally invasive Impella 5.0 via the right subclavian artery cutdown for acute on chronic decompensated heart failure as a bridge to decision". Ochsner Journal. 16 (3): 210–216. PMC 5024800. PMID 27660567.
  3. ^ "How Abiomed became a major medical device company". 10 October 2017.
  4. ^ "Explore Impella® Technology for Heart Recovery".
  5. ^ a b "Impella Ventricular Support Systems - P140003/S018". www.fda.gov. Archived from the original on 2018-04-24.
  6. ^ "Stocks". Bloomberg News.
  7. ^ Amin, AP; Spertus, JA; Curtis, JP; Desai, N; Masoudi, FA; Bach, RG; McNeely, C; Al-Badarin, F; House, JA; Kulkarni, H; Rao, SV (28 January 2020). "The Evolving Landscape of Impella Use in the United States Among Patients Undergoing Percutaneous Coronary Intervention With Mechanical Circulatory Support". Circulation. 141 (4): 273–284. doi:10.1161/CIRCULATIONAHA.119.044007. PMID 31735078. S2CID 208143531.
  8. ^ Ouweneel, DM; Schotborgh, JV; Limpens, J; Sjauw, KD; Engström, AE; Lagrand, WK; Cherpanath, TG; Driessen, AH; de Mol, BA; Henriques, JP (December 2016). "Extracorporeal life support during cardiac arrest and cardiogenic shock: a systematic review and meta-analysis". Intensive Care Medicine. 42 (12): 1922–1934. doi:10.1007/s00134-016-4536-8. PMC 5106498. PMID 27647331.
  9. ^ Alushi, B; Douedari, A; Froehlig, G; Knie, W; Wurster, TH; Leistner, DM; Stahli, BE; Mochmann, HC; Pieske, B; Landmesser, U; Krackhardt, F; Skurk, C (2019). "Impella versus IABP in acute myocardial infarction complicated by cardiogenic shock". Open Heart. 6 (1): e000987. doi:10.1136/openhrt-2018-000987. PMC 6546200. PMID 31218000.
  10. ^ Sef, Davorin; Kabir, Tito; Lees, Nicholas James; Stock, Ulrich (March 2021). "Valvular complications following the Impella device implantation". Journal of Cardiac Surgery. 36 (3): 1062–1066. doi:10.1111/jocs.15303. ISSN 0886-0440. PMID 33410194. S2CID 230818477.
  11. ^ Bossi, Eleonora; Marini, Claudia; Gaetti, Giovanni; Diamanti, Luca; Alessio, Davide; Bertoldi, Letizia Fausta; Pappalardo, Federico; Odone, Anna (2021-10-29). "Efficacy and safety of Impella 5.0 in cardiogenic shock: an updated systematic review". Future Cardiology. 18 (3): 253–264. doi:10.2217/fca-2021-0046. ISSN 1744-8298. PMID 34713720. S2CID 240153209.
  12. ^ Tayal, R; Barvalia, M; Rana, Z; et al. (2016). "Totally percutaneous insertion and removal of Impella device using axillary artery in the setting of advanced peripheral artery disease". Journal of Invasive Cardiology. 28 (9): 374–380. PMID 27430667.
  13. ^ "Impella".
  14. ^ a b Sauren, LD; Accord, RE; Hamzeh, K; et al. (2007). ""Combined Impella and intra-aortic balloon pump support to improve both ventricular unloading and coronary blood flow for myocardial recovery " an experimental study". Artificial Organs. 31 (11): 839–842. doi:10.1111/j.1525-1594.2007.00477.x. PMID 18001394.
  15. ^ a b Seyfarth, M; Sibbing, D; Bauer, I; et al. (2008). "A randomized clinical trial to evaluate the safety and efficacy of a percutaneous left ventricular assist device versus intra-aortic balloon pumping for treatment of cardiogenic shock caused by myocardial infarction". Journal of the American College of Cardiology. 52 (19): 1584–1588. doi:10.1016/j.jacc.2008.05.065. PMID 19007597.
  16. ^ Kawashima, D; Gojo, S; Nishimura, T; et al. (2011). "Left ventricular mechanical support with Impella provides more ventricular unloading in heart failure than extracorporeal membrane oxygenation". ASAIO Journal. 57 (3): 169–176. doi:10.1097/MAT.0b013e31820e121c. PMID 21317769. S2CID 20486030.
  17. ^ Meyns, B; Stolinski, J; Leunens, V; Verbeken, E; Flameng, W (2003). "Left ventricular support by catheter-mounted axial flow pump reduces infarct size". Journal of the American College of Cardiology. 41 (7): 1087–1095. doi:10.1016/S0735-1097(03)00084-6. PMID 12679206.
  18. ^ Remmelink, M; Sjauw, KD; Henriques, JP; et al. (2007). "Effects of left ventricular unloading by Impella recover LP2.5 on coronary hemodynamics". Catheterization and Cardiovascular Interventions. 70 (4): 532–537. doi:10.1002/ccd.21160. PMID 17896398. S2CID 36884928.
  19. ^ Spiro, J; Doshi, SN (2014). "Use of left ventricular support devices during acute coronary syndrome and percutaneous coronary intervention". Current Cardiology Reports. 16 (12): 544. doi:10.1007/s11886-014-0544-x. PMID 25326728. S2CID 41290964.
  20. ^ La Torre, MW; Centofanti, P; Attisani, M; Patanè, F; Rinaldi, M (2011). "Posterior ventricular septal defect in presence of cardiogenic shock: early implantation of the Impella recover LP 5.0 as a bridge to surgery". Texas Heart Institute Journal. 38 (1): 42–49. PMC 3060738. PMID 21423467.
  21. ^ Cheng, JM; den Uil, CA; Hoeks, SE; et al. (2009). ""Percutaneous left ventricular assist devices vs. intra-aortic balloon pump counterpulsation for treatment of cardiogenic shock " a meta-analysis of controlled trials". European Heart Journal. 30 (17): 2102–2108. doi:10.1093/eurheartj/ehp292. PMID 19617601.
  22. ^ "FDA 510(k) clearance". Food and Drug Administration. 31 August 2021.
  23. ^ "FDA approves blood pump system to help patients maintain stable heart function during certain high-risk cardiac procedures [press release]. Rockville, MD: US Food and Drug Association. March 23, 2015. Updated March 27, 2015". Food and Drug Administration.
  24. ^ "FDA approves blood pump system to help patients maintain stable heart function during certain high-risk cardiac procedures [press release]. Rockville, MD: US Food and Drug Association. March 23, 2015. Updated March 27, 2015". Food and Drug Administration.
  25. ^ "US Food and Drug Association. 510(k) Summary – Impella 5.0" (PDF).
  26. ^ "US Food and Drug Association. 510(k) Summary – Impella Controller" (PDF).
  27. ^ "Humanitarian Device Exemption (HDE). US Food and Drug Administration".
  28. ^ Amin, Amit P.; Spertus, John A.; Curtis, Jeptha P.; Desai, Nihar; Masoudi, Frederick A.; Bach, Richard G.; McNeely, Christian; Al-Badarin, Firas; House, John A.; Kulkarni, Hemant; Rao, Sunil V. (28 January 2020). "The Evolving Landscape of Impella Use in the United States Among Patients Undergoing Percutaneous Coronary Intervention With Mechanical Circulatory Support". Circulation. 141 (4): 273–284. doi:10.1161/CIRCULATIONAHA.119.044007. PMID 31735078. S2CID 208143531.
  29. ^ "FDA Announces Class I Recall of All Left-Sided Impella Pumps". HCP Live. 2023-07-27. Retrieved 2024-03-29.
  30. ^ "Abiomed's latest Impella recall linked to 129 injury, 49 death reports". MedTech Dive. Retrieved 2024-03-29.
  31. ^ "FDA Warns About Impella Left-Sided Blood Pumps, Linked to 49 Deaths". HCP Live. 2024-03-29. Retrieved 2024-03-29.
  32. ^ "Abiomed Impella 'Instruction for Use' Recall Linked to 49 Deaths". www.mddionline.com. Retrieved 2024-03-29.

Read other articles:

Bossam

BossamBossamNama KoreaHangul보쌈 Hanjanone Alih AksarabossamMcCune–Reischauerpossam Bossam adalah salah satu jenis ssam dalam masakan Korea berupa daging babi rebus yang dimakan setelah di atasnya diberi kimchi dan dibungkus dengan daun selada. Makanan ini juga dihidangkan bersama penyedap berupa saus (yangnyeom), ssamjang, bawang putih mentah, irisan bawang bombay, atau tiram segar. Bossam juga sering dimakan bersama saeujeot. Daging babi untuk bossam adalah daging bagian perut yang dire...

 

The Sphinx (poem)

Poem by Oscar Wilde The title-page of the first edition of The Sphinx, with decorations by Charles Ricketts The Sphinx is a 174-line poem by Oscar Wilde, written from the point of view of a young man who questions the Sphinx in lurid detail on the history of her sexual adventures, before finally renouncing her attractions and turning to his crucifix. It was written over a period of twenty years, stretching from Wilde's years as an Oxford student up to the poem's publication in an édition de ...

 

STS-122

Kru STS-122. STS-122 adalah misi Pesawat Ulang Alik NASA menuju Stasiun Luar Angkasa Internasional (ISS). STS-122 diterbangkan menggunakan Pesawat Ulang Alik Atlantis. STS-122 menandai misi peluncuran ke-24 ke ISS, dan penerbangan Pesawat Ulang Alik ke-121 sejak STS-1. Tujuan utama STS-122 adalah untuk mengantarkan laboratorium ilmu pengetahuan Columbus yang dibangun oleh European Space Agency (ESA) ke stasiun. STS-122 juga akan mengembalikan Insinyur Penerbangan Expedition 16, Daniel M. Tani...

Gibson Barney Kessel

Hollow body guitar by Gibson, 1961 to 1974 Barney Kessel1964 Gibson Barney Kessel customManufacturerGibson BrandsPeriod1961–1974ConstructionBody typeSemi-hollow body thinlineScale25 1/2WoodsBodySpruce and MapleNeckMahoganyFretboardBrazilian rosewoodHardwareBridgeRosewoodPickup(s)HumbuckersColors availableSunburst The Gibson Barney Kessel (1961–1974) is a signature model guitar manufactured by the Gibson Guitar Company. The guitar was a signature model for the popular Jazz musician Barney...

 

Basilika Santo Petrus Fourier, Mattaincourt

Basilika Santo Petrus FourierBasilika Minor Santo Petrus FourierPrancis: Basilique Saint-Pierre-Fourier de MattaincourtBasilika Santo Petrus FourierLokasiMattaincourtNegara PrancisDenominasiGereja Katolik RomaArsitekturStatusBasilika minorStatus fungsionalAktif Basilika Santo Petrus Fourier (Prancis: Basilique Saint-Pierre-Fourier de Mattaincourt) adalah sebuah gereja basilika minor Katolik yang terletak di Mattaincourt, Prancis. Basilika ini ditetapkan statusnya pada 1897 dan di...

 

Garden Hill (Hong Kong)

Hill in Hong Kong Garden Hill嘉頓山View of Garden HillHighest pointElevation90 m (300 ft)Coordinates22°20′11.5″N 114°9′49.0″E / 22.336528°N 114.163611°E / 22.336528; 114.163611GeographyGarden HillLocation of Garden Hill in Hong Kong Location Hong Kong Garden Hill (Chinese: 喃嘸山; Cantonese Yale: nàahm mòuh shāan; or 嘉頓山; gā déun shāan) is a 300-foot-tall (90.6-metre) hill in the Sham Shui Po District in northwe...

Greenwich Savings Bank Building

Historic bank building in Manhattan, New York United States historic placeGreenwich Savings BankU.S. National Register of Historic PlacesNew York State Register of Historic PlacesNew York City Landmark No. 1766, 1767 Sixth Avenue facadeLocation1352–1362 Broadway, Manhattan, New YorkCoordinates40°45′05″N 73°59′14″W / 40.75139°N 73.98722°W / 40.75139; -73.98722Built1922ArchitectYork & SawyerArchitectural styleClassical RevivalNRHP re...

 

Linth

LinthIl canale della Linth.Stato Svizzera Cantoni Glarona San Gallo Svitto Lunghezza60 km Portata media55,1 m³/s Bacino idrografico1 061 km² Nascemassiccio del Tödi SfociaLago di Zurigo Modifica dati su Wikidata · Manuale La Linth è un fiume della Svizzera che attraversa i cantoni di Glarona, San Gallo e Svitto. Indice 1 Percorso 2 Storia 3 Note 4 Altri progetti 5 Collegamenti esterni Percorso Ha la sua sorgente nel massiccio del Tödi, quindi scorre verso n...

 

40 Years of Silence: Sebuah Tragedi Indonesia

40 Years of Silence: An Indonesian Tragedy adalah sebuah film dokumenter yang dibuat oleh antropolog Robert Lemelson tentang efek pribadi terhadap pembantaian di Indonesia 1965–1966. Film ini diambil di pulau Bali dan Jawa pada periode 2002-2006. Latar belakang musik tersebut merupakan kolaborasi antara komposer Inggris Malcolm Cross dan musisi Bali Nyoman Wenten, dan menggabungkan tonalities Barat dan struktur chordal dengan skalar Bali dan Jawa deret dan melodi. Film ini dirilis di Amerik...

Yellow Emperor

Mythical Chinese sovereign For Huangdi (Emperor of China), see Emperor of China. Yellow Emperor黃帝The Yellow Emperor as depicted in a tomb from the mid 2nd century AD. The inscription reads: The Yellow Emperor created and changed a great many things; he invented weapons and the well-field system; he devised upper and lower garments, and established palaces and houses.[1]PredecessorFuxiSuccessorZhuanxu or ShaohaoBornGongsun XuanyuanSpouse Leizu Fenglei Tongyushi Momu Issue Shaohao C...

 

Nuevo León

Para otros usos de este término, véase Nuevo León (desambiguación). Nuevo León Estado De arriba a abajo, izquierda y derecha; Vista panorámica de Monterrey, Catedral de Monterrey, Edificios en San Pedro Garza García, Parroquia de Santiago Apóstol en Villa de Santiago, Grutas de Bustamante, Palacio de gobierno del estado de Nuevo León, Edificios en la zona metropolitana de Monterrey y Museo del Obispado Escudo Lema: Semper Ascendens(latín, «Siempre Ascendiendo»). Localización de ...

 

Bataille de la mer de Bismarck

Bataille de la mer de Bismarck Déroulement de la bataille de la mer de Bismarck Informations générales Date du 2 au 4 mars 1943 Lieu Mer de Bismarck à proximité de Lae, Nouvelle-Guinée Issue Victoire décisive alliée Belligérants États-Unis Australie Empire du Japon Commandants George Kenney Kimura Masatomi Forces en présence 39 bombardiers lourds41 bombardiers moyens34 bombardiers légers54 chasseurs 8 destroyers 8 transports de troupes 100 avions de combat, basés au sol Pertes 1...

Joel Castro Pereira

Professional footballer This article is about the goalkeeper. For the defender, see Joel Pereira (footballer, born September 1996). In this Portuguese name, the first or maternal family name is Castro and the second or paternal family name is Pereira. Joel Castro Pereira Pereira warming up for Manchester United in 2017Personal informationFull name Joel Dinis Castro Pereira[1]Date of birth (1996-06-28) 28 June 1996 (age 27)Place of birth Boudevilliers, SwitzerlandHeight 1.88&#...

 

Sudipo Handoyo

Sudipo Handoyo Informasi pribadiLahir27 Agustus 1958 (umur 65)JakartaKebangsaanIndonesiaAlma materAkademi Angkatan Udara (1982)Penghargaan sipil504915Karier militerPihak IndonesiaDinas/cabang TNI Angkatan UdaraMasa dinas1982 – 2016Pangkat Marsekal Muda TNISatuanKorps PenerbangSunting kotak info • L • B Marsekal Muda TNI (Purn.) Sudipo Handoyo, S.E., M.M. (lahir 27 Agustus 1958) adalah seorang Purnawirawan perwira tinggi TNI Angkatan Udara. terakhir kali berdinas...

 

1975 Vuelta a España

Cycling race 1975 Vuelta a EspañaRace detailsDates22 April – 11 MayStages19 stages + Prologue, including 2 split stagesDistance3,104 km (1,929 mi)Winning time88h 00' 56Results Winner  Agustín Tamames (ESP) (Super Ser)  Second  Domingo Perurena (ESP) (Kas)  Third  Miguel María Lasa (ESP) (Kas) Points  Miguel María Lasa (ESP) (Kas) Mountains  Andrés Oliva (ESP) (Kas)  Sprints  Fernando Mendes (POR) (Spor...

Vittore Bocchetta

Italian sculptor, painter, and academic (1918–2021) Vittore Bocchetta (15 November 1918 – 18 February 2021) was a Sardinia-born Italian sculptor, painter, and academic. Bocchetta was a member of the anti-fascist Italian resistance movement during World War II. Bocchetta in 2001 Biography Vittore Bocchetta was born in Sassari, Sardinia to a military engineer. After his childhood in Sardinia, he moved with his family first to Bologna and then to Verona. Even if belonging to a family of arti...

 

Demi Lovato: Simply Complicated

2017 American filmDemi Lovato: Simply ComplicatedFilm posterDirected byHannah Lux DavisProduced by Sean Cooley Jamee Ranta StarringDemi LovatoCinematographyCarlos VeronEdited byGrant MacDowellMusic by Demitri Lerios Michael Lerios ProductioncompanyPhilymack ProductionsDistributed byYouTubeRelease date October 17, 2017 (2017-10-17) Running time78 minutesCountryUnited StatesLanguageEnglish This past year has been one of the most transformative years of my life, and I’m looking ...

 

佳子内親王

この項目では、秋篠宮文仁親王第2女子について説明しています。第71代・後三条天皇第3皇女については「佳子内親王 (後三条天皇皇女)」をご覧ください。 佳子内親王 秋篠宮家 2020年（令和2年）5月1日 撮影続柄 秋篠宮文仁親王第2女子[1]全名 佳子（かこ）身位 内親王敬称 殿下お印 ゆうな出生 (1994-12-29) 1994年12月29日（29歳） 日本・東京都千代田区千代田皇居・宮�...

Camshaft

Mechanical component that converts rotational motion to reciprocal motion For the fictional characters of the same name, see Camshaft (Transformers). A camshaft operating two valves A camshaft is a shaft that contains a row of pointed cams in order to convert rotational motion to reciprocating motion. Camshafts are used in piston engines (to operate the intake and exhaust valves),[1][2] mechanically controlled ignition systems and early electric motor speed controllers. Camsha...

 

Léon Gambetta

French politician (1838–1882) For other uses, see Léon Gambetta (disambiguation). Léon GambettaGambetta photographed by Étienne CarjatPrime Minister of FranceIn office14 November 1881 – 30 January 1882PresidentJules GrévyPreceded byJules FerrySucceeded byCharles de FreycinetPresident of the Chamber of DeputiesIn office31 January 1879 – 27 October 1881Preceded byJules GrévySucceeded byHenri BrissonMinister of the InteriorIn office4 September 1870 – 6 Feb...