Six years' experience with closed-chest decannulation of transthoracically inserted cardiac-assist balloon catheters

Area of Science:

• Cardiovascular Surgery
• Medical Devices
• Anesthesiology

Background:

• Intraoperative cardiac-assist balloon catheter insertion is crucial for managing hemodynamic instability.
• Conventional transfemoral insertion may be contraindicated or technically challenging in certain open-heart surgeries.

Purpose of the Study:

• To assess the efficiency and risks of a closed-chest decannulation technique for intraoperatively inserted cardiac-assist balloon catheters.
• To evaluate the safety and efficacy of this alternative removal method.

Main Methods:

• The technique involves direct insertion into the ascending aorta, protected by a silastic tourniquet.
• The tourniquet can be removed intraoperatively or via a small infrasternal incision.
• The method was applied to 18 patients over a 6-year period (May 1985 - June 1991).

Main Results:

• Satisfactory cardiac assistance was achieved in all 18 patients.
• No early or late complications or deaths were attributed to the closed-chest decannulation technique.
• Nine patients were still alive at the time of the report.

Conclusions:

• The closed-chest decannulation method is an efficient and safe procedure for cardiac-assist balloon catheters.
• This technique is recommended when conventional transfemoral insertion is impossible or inadvisable during open-heart operations.