A new application of counterpulsation: safer laparotomy after recent myocardial infarction.
A 56-year old man suffered severe gastrointestinal tract bleeding five days following an anterior myocardial infraction. Nonoperative treatment consisting of gastric lavage, selective angiographic procedures on the gastric arteries with intra-arterial vasopressin injection (Pitressin), and massive blood replacement over a five-day period failed to halt hemorrhage. Institution of intra-aortic balloon pumping reversed the patient's hemodynamic deterioration and made possible a definitive operation. The successful outcome in this patient suggests that counterpulsation may play a useful role in lowering the formidable surgical mortality observed in patients with acute myocardial injury who require emergency noncardiac operations.
D000792:Angiography; D001243:Assisted Circulation / Q000379:methods*; D001794:Blood Pressure; D002302:Cardiac Output; D006471:Gastrointestinal Hemorrhage / Q000150:complications / Q000601:surgery*; D006439:Hemodynamics; D006801:Humans; D007213:Indomethacin / Q000627:therapeutic use; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000517:prevention & control; D010493:Pericarditis / Q000150:complications / Q000188:drug therapy
D007213:Indomethacin