Retained intraaortic balloon. Case report and review of the literature
Related Experiment Videos
A M Grande1, L Martinelli, A Graffigna
1Divisione di Cardiochirurgia, Istituto Chirurgia Generale e dei Trapianti d'Organo, IRCCS Policlinico, San Matteo, Università, degli Studi di Pavia, Italy.
Insights
Intraaortic balloon rupture led to clot formation and entrapment at the aortic bifurcation in a patient with severe atherosclerosis. Surgical intervention successfully removed the balloon, and the patient recovered well.
Area of Science:
- Cardiovascular Surgery
- Vascular Surgery
- Interventional Cardiology
Background:
- Intraaortic balloon pumps (IABP) are critical for hemodynamic support in high-risk cardiac procedures.
- Complications, though rare, can arise from IABP use, necessitating prompt recognition and management.
- Severe atherosclerosis increases the risk of vascular complications during and after cardiac interventions.
Observation:
- A 70-year-old male patient developed intraaortic balloon entrapment following emergency triple coronary artery bypass surgery.
- The entrapment occurred at the aortic bifurcation due to a ruptured intraaortic balloon, which had formed an internal clot.
- The patient presented with severe atherosclerosis affecting the aorta and iliac arteries.
Findings:
- Intraaortic balloon rupture was identified as the cause of clot formation and subsequent entrapment.
- Surgical intervention, involving aorto-iliac exposure and aorto-bifemoral bypass, was required for balloon removal.
- The patient experienced a successful outcome with complete symptom resolution.
Implications:
- This case highlights the importance of considering rare complications like balloon entrapment in patients with significant atherosclerosis undergoing cardiac surgery.
- Prompt diagnosis and surgical management are crucial for favorable outcomes in intraaortic balloon entrapment.
- Aorto-iliac exposure and bypass grafting represent a viable surgical strategy for managing complex balloon entrapment scenarios.
Abstract:
We report a case of intraaortic balloon entrapment in a 70-year-old man who underwent emergency triple coronary bypass. Intraaortic balloon rupture caused the formation of a clot inside the balloon that eventually was responsible for the balloon's entrapment at the aortic bifurcation. The patient had severe atherosclerosis of the aorta and iliac arteries. Balloon removal required aorto-iliac exposure and aorto-bifemoral bypass. After 16 months, he is symptom free and at home.