Mechanical left ventricular support using a 50 cc 8 Fr fibre-optic intra-aortic balloon technology: a case report

More than four decades have passed since the first clinical use of an (IABP) to improve the clinical scenario for patients with chronic left ventricular failure. The original IAB catheter size was 15 French (Fr), requiring an open surgical insertion and removal. This therapy has now become the most widely used mechanical device for failure of the left ventricle. The introduction of an 8 Fr fibre-optic IAB catheter with a 50 cc diastolic blood volume displacement has further increased the potential clinical impact of this technology. This new catheter can be used for all patients over 162 cm in height, allowing a broader spectrum of patients to benefit from increased diastolic blood volume displacement and fibre-optic pressure monitoring. The catheter has been designed on an 8 Fr shaft platform, potentially reducing the incidence of vascular complications. We present our case report on the world's first implant of this 50cc 8 Fr IAB catheter.

Cardiac investigations on a 53-year-old man showed the patient to have ischaemic dilated cardiomyopathy with a left ventricular ejection fraction (LVEF) of 25%. An 8 Fr 50cc Sensation PlusTM IAB catheter was inserted pre-operatively, prior to coronary artery bypass grafting.

The world's first insertion of this 8 Fr 50 cc IAB catheter was a complete success, with no complications. The patient's pre-, peri- and post-operative courses were as we expected and event free, underpinned by IABP support.

This new 50 cc, 8 Fr IAB expands the patient group that can benefit from greater diastolic blood volume delivery, improved distal perfusion, more accurate monitoring, subsequent better beat-per-beat support and, finally, the reduced complication rates associated with an 8 Fr shaft.