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[Extensive bowel infarction caused by intraaortic balloon pumping]

M Haga1, T Sasajima, H Asada

  • 1First Department of Surgery, Asahikawa Medical College, Japan.

[Zasshi] [Journal]. Nihon Kyobu Geka Gakkai
|January 1, 1993
PubMed
Summary

Intra-aortic Balloon Pumping (IABP) can lead to extensive bowel infarction, particularly in patients with severe arteriosclerosis. This complication, seen in two cases, resulted in peritonitis and death despite surgical intervention.

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Area of Science:

  • Cardiology
  • Gastroenterology
  • Vascular Surgery

Background:

  • Intra-aortic Balloon Pumping (IABP) is a mechanical circulatory support device used in critical cardiovascular conditions.
  • Severe arteriosclerotic lesions, especially in the aorta, represent a significant risk factor in cardiovascular interventions.

Observation:

  • Two cases are presented where patients developed extensive bowel infarction during IABP support.
  • Case 1: Developed bowel infarction 5 days after IABP initiation for acute myocardial infarction post-lower leg arterial reconstruction.
  • Case 2: Experienced bowel infarction within 2 days of IABP support for weaning from cardiopulmonary bypass after coronary artery bypass grafting.

Findings:

  • Both patients presented with peritonitis secondary to extensive small and large intestine infarction.

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  • Microscopic examination in Case 1 revealed cholesterol emboli in small bowel arteries.
  • Despite surgical resection of necrotic bowel, both patients succumbed to cardiopulmonary and renal failure.

    • Implications:

    • IABP use should be carefully considered in patients with severe aortic arteriosclerosis due to the risk of mesenteric ischemia.
    • Early recognition and management of bowel infarction during IABP are crucial, though outcomes remain poor.
    • This highlights the importance of pre-procedural risk assessment for aortic conditions before initiating IABP.