Operative intra-aortic balloon rupture.
Rupture of an intra-aortic balloon (IAB), inserted to assist in weaning from cardiopulmonary bypass, occurred during attempted intra-aortic administration of protamine in a 71-year-old male who later died. Intra-aortic balloon counterpulsation (IABC) is most commonly utilized to assist in weaning from cardiopulmonary bypass (CPB) or to augment low-flow states following CPB. In-hospital survival following IAB insertion in these circumstances in patients with coronary artery disease is approximately 60 per cent. Patients with valvular disease have a lower in-hospital survival rate (50 per cent). Complications of IABC are usually of vascular or infectious origin. Balloon rupture is a rare though potentially lethal complication. The effects of balloon rupture may be compounded by the use of helium as a driving gas to inflate the balloon. Intra-aortic administration of protamine has not been shown to be superior to peripheral administration and should be avoided if an IAB is in place.
Finegan
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BA
Department of Anaesthesia, University of Alberta, Edmonton.
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D000368:Aged; D001011:Aorta; D002315:Cardiopulmonary Bypass; D005740:Gases; D006801:Humans; D007423:Intra-Aortic Balloon Pumping / Q000009:adverse effects*; D008297:Male; D011479:Protamines / Q000008:administration & dosage
D005740:Gases; D011479:Protamines