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The Intra-Aortic Balloon Pump
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Intraoperative intra-aortic balloon pump insertion: step by step.

Carla Gotsens-Asenjo1, Constanza Fernández-De Vinzenzi1, Elena Roselló-Díez1

  • 1Department of Cardiac Surgery, Hospital de la Santa Creu i Sant Pau - Sant Pau Biomedical Research Institute (IIB SANT PAU), Barcelona, Spain.

Multimedia Manual of Cardiothoracic Surgery : MMCTS
|October 18, 2024
PubMed
Summary
This summary is machine-generated.

This study highlights the successful use of an intra-aortic balloon pump (IABP) to stabilize a patient with severe left ventricular dysfunction during urgent off-pump coronary artery bypass grafting surgery.

Keywords:
Aorto-coronary bypassCirculatory support devicesIntra-aortic balloon pump

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Area of Science:

  • Cardiovascular Surgery
  • Cardiology
  • Medical Devices

Background:

  • A 76-year-old patient presented with non-ST elevation myocardial infarction and severe left ventricular dysfunction.
  • Coronary angiography revealed significant left main and two-vessel coronary artery disease, necessitating urgent surgical intervention.

Observation:

  • An intra-aortic balloon pump (IABP) was inserted pre-operatively under echocardiographic guidance to ensure hemodynamic stability.
  • The IABP catheter was positioned in the descending thoracic aorta, confirmed by transesophageal echocardiography.
  • The patient underwent double off-pump coronary artery bypass grafting via median sternotomy.

Findings:

  • The intra-aortic balloon pump effectively maintained hemodynamic stability throughout the complex surgical procedure.
  • The patient was extubated shortly after surgery, and the IABP was removed on postoperative day two without complications.

Implications:

  • Intra-aortic balloon pump support is a valuable strategy for managing patients with compromised left ventricular function undergoing off-pump coronary artery bypass grafting.
  • This case demonstrates the feasibility and safety of IABP use in high-risk cardiac surgery patients.
  • Optimized hemodynamic management, including IABP use, can lead to favorable outcomes in complex coronary artery disease cases.