Document Detail


Trans-aortic counterpulsation: a viable alternative?
MedLine Citation:
PMID:  17672190     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Transthoracic intra-aortic balloon pump (IABP) insertion has been a relatively rare and uncommon procedure. However, it is an established beneficial option in patients with severe peripheral vascular disease (PVD) accompanied with bi-lateral femoral arterial occlusion. There are several viable alternatives to trans-aortic IABP insertion, including trans-axillary or in abdominal aorta (requiring a laparotomy). Cardiac surgery has the advantage of an open sternum, facilitating effortless direct intra-aortic balloon (IAB) insertion into the aorta. The IAB can be inserted either through a 9-mm graft or directly into the ascending aorta. During cardiac surgery, direct insertion into the ascending aorta with the balloon tip lying distally in the abdominal aorta is facilitated with an open sternum. The base of the balloon lies approximately 2 cm below the left subclavian and can be confirmed through a trans-esophageal echocardiogram (TEE). Elimination of a graft insertion saves the team from time-consuming maneuvers and additional hemorrhagic complications. In our experience, postoperative vasoplegic syndrome coupled with myocardial edema contributed to patent instability and was treated with vasopressin and transthoracic IAB insertion. The CS 100 (Datascope Corp., Mahwah, NJ) console allowed the ability to time the balloon accurately. This case report details our experience with one such patient and establishes trans-aortic counter-pulsation as a safe and viable option in patients with severe PVD, where percutaneous insertion is precluded or has failed.
Authors:
Bharat Datt; Lisa Hutchison; Charles Peniston
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The Journal of extra-corporeal technology     Volume:  39     ISSN:  0022-1058     ISO Abbreviation:  J Extra Corpor Technol     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-08-03     Completed Date:  2007-10-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0267637     Medline TA:  J Extra Corpor Technol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  91-5     Citation Subset:  T    
Affiliation:
Department of Perfusion Services, Southlake Regional Health Centre, Newmarket, Ontario, Canada. bdatt@southlakeregional.org
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged
Cardiomyopathies / therapy*
Counterpulsation / instrumentation*,  methods
Edema, Cardiac / therapy*
Humans
Intra-Aortic Balloon Pumping / instrumentation*
Male
Peripheral Vascular Diseases / therapy*
Postoperative Complications
Vasopressins
Chemical
Reg. No./Substance:
11000-17-2/Vasopressins

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Evaluating the efficacy of intra-aortic balloon pump timing using the auto-timing mode of operation ...
Next Document:  Innovative design to prevent reversal of roller blood pump rotation in the event of electromechanica...