Transaxillary Intra-Aortic Balloon Pump Migration Minimized With a Long Introducer Sheath

Area of Science:

• Cardiovascular Surgery
• Medical Devices
• Transplantation Medicine

Background:

• Intra-aortic balloon pumps (IABP) support patients awaiting cardiac transplantation.
• The transaxillary approach offers improved mobility over femoral insertion.
• However, transaxillary IABPs are prone to migration, leading to complications.

Observation:

• A 67-year-old male received a transaxillary IABP for pre-transplant rehabilitation.
• The patient had an unfolded aorta, causing the IABP to repeatedly coil and migrate.
• This migration posed risks of vascular injury and disqualification from transplantation.

Findings:

• A novel technique utilizing a long 25-cm introducer sheath was employed.
• This method effectively mitigated the migration of the transaxillary IABP.
• The patient was able to continue with pre-transplant physical rehabilitation.

Implications:

• This technique offers a potential solution for managing IABP migration in specific patient anatomies.
• It may enhance the safety and efficacy of transaxillary IABP use in bridge-to-transplant scenarios.
• Further studies are warranted to validate this approach in a broader patient population.