Multiple Small Foley Balloons for Large Cardiac or Vascular Lacerations

Area of Science:

• Cardiovascular Surgery
• Vascular Surgery
• Emergency Medicine

Background:

• Foley balloons have been a staple for emergency hemostasis in cardiac and vascular injuries since the 1960s.
• A single, large Foley balloon may lead to inadequate hemostasis and compromise blood flow, presenting significant clinical challenges.

Purpose of the Study:

• To evaluate the efficacy of using multiple small Foley balloons for managing major intraoperative cardiac and vascular lacerations.
• To address the limitations associated with the traditional use of a single large Foley balloon in critical surgical scenarios.

Main Methods:

• The study retrospectively reviewed three cases of major intraoperative lacerations occurring since 2011.
• Laceration sites included the inferior vena cava (2.5 cm), main pulmonary artery (2 cm), and right ventricle (5 cm).
• Management involved the application of multiple small (10F-14F) Foley balloons, partially inflated.

Main Results:

• Successful hemostasis was achieved in all three critical laceration cases using the described technique.
• The use of multiple small, half-inflated balloons effectively controlled bleeding from large-diameter vessel and cardiac injuries.

Conclusions:

• Employing multiple small Foley balloons is a viable and effective strategy for managing extensive intraoperative cardiac and vascular lacerations.
• This approach mitigates the drawbacks of single large balloon use, offering improved hemostasis and reduced blood flow impairment.