A New 35-mm Short Intra-aortic Balloon Catheter: A Suitable Option also for Non-Small-Sized Patients?

Author(s):  
Sandro Gelsomino ◽  
Pieter Willem Lozekoot ◽  
Roberto Lorusso ◽  
Monique Maria de Jong ◽  
Orlando Parise ◽  
...  

Objective Visceral ischemia can be a potentially life-threatening complication of intra-aortic balloon pump (IABP) support. A shorter IABP catheter might lead to a reduction of visceral complications. In this animal study, we evaluate the effects of a 35-mL short catheter in comparison with a 40-mL standard-sized catheter. Methods Eighteen healthy swine underwent 120-minute ligation of the left anterior descending coronary artery followed by 6 hours of reperfusion being supported by either a short IABP catheter (short group) (n = 6) or a long IABP catheter (long group) (n = 6) or with no assistance (controls) (n = 6). Hemodynamics, visceral and coronary flows, as well as biochemical markers were evaluated throughout the different phases of the protocol. Results Mesenteric flows increased significantly at reperfusion (P < 0.001 both) remaining constant afterward (all, P > 0.05) in the short group, while remaining significantly lower in the long group at the start of reperfusion, remaining constantly lower than the short group and controls (P < 0.001 vs short, P < 0.003 vs controls). In both long and short groups, catheters improved renal flows at reperfusion (P < 0.001 both) without any further variation (P < 0.05). In the short group, the flows were higher during the whole of reperfusion (all, P < 0.05). Intra-aortic balloon pump support improved hemodynamic indices and coronary blood flows during reperfusion to a similar extent in both the small and the long group (P > 0.05). Conclusions The short IABP catheter proved to be as effective as the standard-sized catheter in supporting hemodynamics and coronary circulation. Furthermore, it even improves visceral flows in comparison with conventional IABP catheters.

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Faruk Toktas ◽  
Senol Yavuz ◽  
Cuneyt Eris ◽  
Suleyman Surer

Background. Intra-aortic balloon pump (IABP) is the most widely used mechanical assist device for hemodynamic support in high risk patients undergoing cardiac surgery. The aim of our study was to confirm whether transaortic route is a suitable alternative to allow IABP insertion in patients with severe aortoiliac diseases.Methods. This study included 7 consecutive patients undergoing coronary artery bypass grafting for severe coronary artery disease associated with severe aortoiliac disease. These patients could not be weaned from cardiopulmonary bypass and required the IABP support, which were placed through the ascending aorta. IABP catheter was inserted indirectly through a separate saphenous vein graft anastomosed to the ascending aorta by an end-to-side manner under a partial occluding clamp and advanced to the desired position in the descending thoracic aorta and exteriorly brought into the subcutaneous tissues in the jugulum.Results. The procedure was successfully performed in all the patients. The mean duration of IABP support was54.0±13.4hours. There were no in-hospital mortality and complications related to transaortic route. IABP removal did not require repeat sternotomy. At postoperative 6th month, multislice CT examination showed thrombotic occlusion at the remnant of the saphenous vein graft.Conclusions. This technique is a simple, reliable, and reproducible option in patients with severe aortoiliac disease in whom retrograde femoral route is not possible.


2018 ◽  
Vol 12 (1) ◽  
pp. 50-54 ◽  
Author(s):  
George Kassimis ◽  
Tushar Raina

Catheter-induced aortic dissection during coronary angiography and Percutaneous Coronary Intervention (PCI) is a relatively infrequent, but potentially life-threatening complication. Patients who suffer this complication may require emergency aortic surgery. More recently, reports of treating the ostium of the dissected coronary artery have emerged as an alternative therapeutic option. In this article we describe two cases of extensive guide catheter induced dissection and their successful treatment using PCI and provide a concise overview of the available literature.


2021 ◽  
Author(s):  
Jing Li ◽  
Liang Dong

Abstract Iatrogenic coronary artery dissection is an uncommon but life-threatening complication of coronary angiography and angioplasty. It may result in devastating consequences if not promptly treated with immediate revascularization. We report a case of recanalization after false lumen stent placement during iatrogenic coronary dissection.


2019 ◽  
Vol 29 (6) ◽  
pp. 971-972
Author(s):  
Yuichiro Kitada ◽  
Mamoru Arakawa ◽  
Atsushi Miyagawa ◽  
Homare Okamura

Abstract Papillary muscle rupture is a rare but life-threatening complication of myocardial infarction (MI). Here, we describe a case of papillary muscle rupture caused by a microscopic MI. A 76-year-old woman was referred to our institution, where she developed cardiac arrest upon admission. Severe mitral regurgitation was noted without significant coronary artery lesions. Emergency surgery was performed, and posteromedial papillary muscle rupture was observed. Postoperatively, cardiac magnetic resonance imaging revealed a microscopic MI of the posteromedial papillary muscle.


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