Document Detail

The carina as a useful radiographic landmark for positioning the intraaortic balloon pump.
MedLine Citation:
PMID:  17717232     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The aortic knob is thought to be the most useful radiographic landmark for the proper positioning of the intraaortic balloon pump (IABP) tip. However, this has not been studied formally. In this study we assessed whether the aortic knob is a reliable landmark for positioning the IABP and compared it with another potential landmark, the carina. METHODS: We measured the distance from the top of the distal aortic arch (aortic knob) to the left subclavian artery (LSCA) on three-dimensional computed tomography angiography in 100 patients. The distance from the level of the LSCA origin to the level of the carina was also measured using three-dimensional computed tomography in 150 additional patients. RESULTS: In 16% of the aortic knob study population, the LSCA to aortic knob distance was <0 cm or 0 cm. The median distance from the LSCA to the carina was 42 mm (range: 30-63 mm). In the carina study population, the origin of the LSCA was 35-55 mm above the carina in 95.3% of patients. CONCLUSION: In 16% of patients, the IABP was too close to the LSCA origin when it was placed at the aortic knob, whereas positioning the IABP at 2 cm above the carina provided an adequate position for the IABP tip (1.5-3.5 cm distal to the origin of the LSCA) in 95.3% of patients. The carina may be a more reliable landmark for positioning the IABP than the aortic knob.
Jin-Tae Kim; Jeong-Rim Lee; Jae-Kwang Kim; Seung Zhoo Yoon; Yunseok Jeon; Jae-Hyon Bahk; Ki-Bong Kim; Chong-Sung Kim; Young-Jin Lim; Hee-Soo Kim; Seong-Deok Kim
Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article    
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  105     ISSN:  1526-7598     ISO Abbreviation:  Anesth. Analg.     Publication Date:  2007 Sep 
Date Detail:
Created Date:  2007-08-24     Completed Date:  2007-09-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  735-8     Citation Subset:  AIM; IM    
Department of Anesthesiology, College of Medicine, Seoul National University, Seoul, Korea.
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MeSH Terms
Aorta, Thoracic / radiography*
Aortography / methods
Coronary Artery Bypass*
Imaging, Three-Dimensional
Intra-Aortic Balloon Pumping* / instrumentation
Middle Aged
Radiographic Image Interpretation, Computer-Assisted
Reproducibility of Results
Retrospective Studies
Subclavian Artery / radiography*
Tomography, X-Ray Computed*
Trachea / radiography*

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

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