| Transbrachial insertion of a 7.5-Fr intra-aortic balloon pump in a severely atherosclerotic patient. | |
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MedLine Citation:
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PMID: 16775570 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Preoperative intra-aortic balloon pumping (IABP) improves the results of complex coronary surgery. However, its insertion may be harmful or contraindicated in cases of severe and diffuse atherosclerosis of the descending aorta and peripheral arteries. We sought to evaluate the efficacy and safety of transbrachial insertion of the new 7.5-Fr IABP to support a severely ill patient with eggshell distal aorta and femoro-iliac arteries undergoing coronary artery bypass grafting (CABG). DESIGN: Case report. SETTING: An 18-bed adult cardiac surgery unit at a university hospital. PATIENT: A 68-yr-old man with ongoing unstable angina, left main disease, and eggshell calcification in the abdominal aorta and iliaco-femoral arteries, needing IABP for CABG. INTERVENTION: Percutaneous sheathless right transbrachial insertion of 7.5-Fr IABP, followed by CABG. MEASUREMENTS AND MAIN RESULTS: Fluoroscopy and chest radiograph were used to confirm the exact position of the IABP, in the preoperative and postoperative time, respectively. A digital pulse oximeter was applied to monitor distal perfusion. Anticoagulation consisted of nadroparin 4000 IU daily until the second postoperative day, followed by 150 mg of aspirin daily thereafter. Transbrachial IABP support allowed uneventful CABG and postoperative course, without IABP-related complications. Pulse oximetry demonstrated constant good values, the radial artery pulse was always present, and the hand appeared constantly warm. IABP was withdrawn 20 hrs following surgery, and the patient was discharged home on the ninth postoperative day. CONCLUSIONS: The miniaturization of IABP, with the recent introduction of a 7.5-Fr balloon catheter, opens the door for the safe, effective transbrachial method of insertion in patients with severe peripheral atherosclerosis. |
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Authors:
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Francesco Onorati; Massimo Bilotta; Francesco Pezzo; Barbara Impiombato; Santo Caroleo; Ermenegildo Santangelo; Attilio Renzulli |
Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Critical care medicine Volume: 34 ISSN: 0090-3493 ISO Abbreviation: Crit. Care Med. Publication Date: 2006 Aug |
Date Detail:
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Created Date: 2006-08-02 Completed Date: 2006-08-31 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0355501 Medline TA: Crit Care Med Country: United States |
Other Details:
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Languages: eng Pagination: 2231-3 Citation Subset: AIM; IM |
Affiliation:
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Cardiac Surgery Unit, Magna Graecia University, Catanzaro, Italy. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Brachial Artery* Coronary Artery Bypass Coronary Artery Disease / surgery* Fluoroscopy Humans Intra-Aortic Balloon Pumping* Male Oximetry Preoperative Care* Punctures |
| Comments/Corrections | |
Comment In:
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Crit Care Med. 2006 Aug;34(8):2259-61
[PMID:
16883205
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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