Attempted balloon catheter obstruction of pulmonary arterial flow in ventricular septal rupture

Leaving a standard balloon flotation catheter inflated in the main pulmonary artery has been recommended as a temporizing measure in patients with post-myocardial infarction ventricular septal rupture. Potential benefit has been ascribed to effective "banding" of the pulmonary artery as in congenital ventricular septal defects. We attempted this technique in five patients with post-infarction septal rupture and shock. In no patient was a significant hemodynamic benefit or reduction in shunt observed. Because of the lack of clearly documented efficacy, the inadequate size of standard pulmonary balloons to produce significant obstruction to pulmonary flow, and the inherent risks of this technique we recommend that it not be lightly attempted.